Vituity Physician Services PC
Organization Active NPI Family Medicine Physician · Fontana, CA
NPI 1124884176 · NPPES record last updated Jul 31, 2024
Key facts
- NPI
- 1124884176
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- VITUITY PHYSICIAN SERVICES PC
- Practice address
- 16888 Baseline Ave
Fontana, CA 92336-2083 - Phone
- (855) 422-8029
- NPI assigned
- Feb 27, 2024
- Organization subpart
- No
Authorized official
- Name
- David Andrew Birdsall
- Title
- Chief Operations Officer
- Phone
- (510) 350-2600
Practitioners 88
-
Shamjana Acharya, NURSE PRACTITIONER
-
David Ahamba, M.D.
-
Muhammad Arif, MD
-
Carlos Alberto Banuelos Ramirez, PHYSICIAN ASSISTANT
-
Peter Bastian, MD
-
Heather Bohn, DO
-
Arnel Cadiz, NURSE PRACTITIONER
-
Luis Miguel Chaname, D.O.
-
Nehemiah Chang, MD
-
Rosa Maria Cortes, M.D.
-
Debra Craig, M.D.
-
Jesse Duro, PA-C
-
James Evans, M.D.
-
Nehal N Gandhi, MD
-
Pooja Gupta, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240506004038 | CA | Part B Supplier - Clinic/Group Practice | 0749620888 |
Receives reassigned benefits from 87 practitioners Practice locations: San Bernardino, CA; Rialto, CA; Redlands, CA; Fontana, CA |
National Provider Directory
Locations
800 E Lugonia Ave
Ste F
Redlands, CA 92374
Phone (855) 422-8029
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
16888 Baseline Ave
Fontana, CA 92336-2083
Mailing address
2100 Powell St Ste 400
Emeryville, CA 94608-1872
Other practice location 1
850 E Foothill Blvd
Rialto, CA 92376-5230
Phone (855) 422-8029
Other practice location 2
800 E Lugonia Ave Ste F
Redlands, CA 92374-2550
Phone (800) 722-4777
Other practice location 3
1499 E Highland Ave
San Bernardino, CA 92404-4611
Phone (855) 422-8029
Other providers in Fontana, CA
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- Visiting Nurses Senior Home Care
- Vista Care Pharmacy Inc
- VK Medical Group Inc
- Stacy Vo
- Trung Duong Vo
- Von Westernhagen Dental Corporation
- Vons Companies Inc
All providers in Fontana, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.