NPIMap

Organization Active NPI

Vista Healthcare, LLC

  • Point of Service
  • Rancho Cucamonga, CA
National Provider Identifier
1083810790
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
Legal business name
VISTA HEALTHCARE, LLC
Practice address
10841 White Oak Ave
Suite 205
Rancho Cucamonga, CA 91730-3811
Phone
(909) 581-7272
Fax
(909) 581-7277
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marc C Ferrell
Title
Senior Vice President
Phone
(909) 581-7272

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X CA Primary

Addresses

Primary practice location

10841 White Oak Ave
Suite 205
Rancho Cucamonga, CA 91730-3811

Mailing address

10841 White Oak Ave
Suite 205
Rancho Cucamonga, CA 91730-3811
Phone (909) 581-7272

National Provider Directory

National Provider Directory

Locations

10841 White Oak Ave
Ste 205
Rancho Cucamonga, CA 91730
Phone (909) 581-7272

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083810790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10841 WHITE OAK AVE",
            "address_2": "SUITE 205",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303811",
            "telephone_number": "909-581-7272",
            "fax_number": "909-581-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10841 WHITE OAK AVE",
            "address_2": "SUITE 205",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303811",
            "telephone_number": "909-581-7272",
            "fax_number": "909-581-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FERRELL",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "909-581-7272"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.