Organization Active NPI

Doctors' Hospital Medical Center of Montclair

  • General Acute Care Hospital
  • Montclair, CA
National Provider Identifier
1093794695
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
DOCTORS' HOSPITAL MEDICAL CENTER OF MONTCLAIR
Practice address
5000 San Bernardino St
Montclair, CA 91763-2326
Phone
(909) 625-5411
Fax
(909) 626-4777
NPI assigned
Jan 11, 2006
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
Mr. David Chu
Title
Chief Executive Officer
Phone
(909) 625-5411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X CA Primary

Addresses

Primary practice location

5000 San Bernardino St
Montclair, CA 91763-2326

Mailing address

5000 San Bernardino St
Montclair, CA 91763-2326
Phone (909) 625-5411

Other identifiers 1

IdentifierTypeStateIssuer
30584OtherMEDI-CAL PROVIDER #

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093794695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 SAN BERNARDINO ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632326",
            "telephone_number": "909-625-5411",
            "fax_number": "909-626-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 SAN BERNARDINO ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632326",
            "telephone_number": "909-625-5411",
            "fax_number": "909-626-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS' HOSPITAL MEDICAL CENTER OF MONTCLAIR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "909-625-5411",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER #",
            "identifier": "30584",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, 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.