Foothills Neurological Medical GP

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

A43523 Issued in CA

Legal business name

FOOTHILLS NEUROLOGICAL MEDICAL GP

Practice address

1330 W Covina Blvd
#103
San Dimas, CA 91773-3200

Phone

(909) 592-2145

Fax

(909) 599-6217

NPI assigned

Sep 21, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Gail E Young, ADMINISTRATOR

Title

Administrator

Phone

(909) 592-2145

Specialties & licenses 2

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Habib Ali Ismail, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • San Dimas, CA
  • NPI 1205893245
  NPD (past)

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1154317584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W COVINA BLVD",
            "address_2": "#103",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733200",
            "telephone_number": "909-592-2145",
            "fax_number": "909-599-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W COVINA BLVD",
            "address_2": "#103",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733200",
            "telephone_number": "909-592-2145",
            "fax_number": "909-599-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS NEUROLOGICAL MEDICAL GP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-592-2145",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A33406",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "A43523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A334060",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A435230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha Alejandra Flores Tabares
• Nevin Flores
• Kean Flowers, LCSW
• Kimberly J Foon, D.D.S.
• Foothill Pediatric & Adolescent Clinic
• Cadence Michelle Foutz
• Genevieve Maya Fragoso
• Kali Jean France, OTR/L
• Evan Franco
• Teresa Adele Franzman, DC

• Neurology with Special Qualifications in Child Neurology Physician in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Neurology with Special Qualifications in Child Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.