NPIMap

Organization Active NPI

Genesis Healthcare System

  • Ambulatory Surgical Clinic/Center
  • Chino, CA
National Provider Identifier
1104150580
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
34087
Legal business name
GENESIS HEALTHCARE SYSTEM
Practice address
11760 Central Ave Ste 125
Chino, CA 91710-1909
Phone
(909) 502-5588
Fax
(909) 902-1013
NPI assigned
Oct 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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

Authorized official

Name
Ms. Connie Finch
Title
Office Manager
Phone
(909) 902-5588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 34087 Primary

Addresses

Primary practice location

11760 Central Ave Ste 125
Chino, CA 91710-1909

Mailing address

11760 Central Ave Ste 125
Chino, CA 91710-1909
Phone (909) 502-5588

National Provider Directory

National Provider Directory

Locations

11760 Central Ave
Ste 125
Chino, CA 91710
Phone (909) 502-5588

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256860800000",
    "number": "1104150580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11760 CENTRAL AVE STE 125",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917101909",
            "telephone_number": "909-502-5588",
            "fax_number": "909-902-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11760 CENTRAL AVE STE 125",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917101909",
            "telephone_number": "909-502-5588",
            "fax_number": "909-902-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2009-10-30",
        "status": "A",
        "authorized_official_last_name": "FINCH",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "909-902-5588",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": "34087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.