Individual provider Active NPI

Sheetal Luthra, DO

  • Pediatrics Physician
  • Fontana, CA
National Provider Identifier
1164604377
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A9625 Issued in CA
Practice address
9961 Sierra Ave
Fontana, CA 92335
Phone
(909) 427-5000
NPI assigned
Nov 29, 2007
Last updated
Nov 29, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20A9625 CA Primary

Addresses

Primary practice location

9961 Sierra Ave
Fontana, CA 92335

Mailing address

3565 Elker Rd
Corona, CA 92882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080508000844 CA Practitioner - Pediatric Medicine 4183703689 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A9625CAMDPediatrics Physician
9625CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare CurrentSince Sep 1, 2022 Accepting new patients
Neighborhood Healthcare CurrentSince Sep 1, 2022 Accepting new patients
Dap Health, Inc. Current Accepting new patients

Locations

308 W 6th St
Ste 109
Corona, CA 92882

425 N Date St
#0
Escondido, CA 92025

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

903 E Devonshire Ave
Ste D
Hemet, CA 92543
Phone (951) 216-6100

41840 Enterprise Cir N
Temecula, CA 92590
Phone (951) 225-6400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sluthra@borregomedical.directbygreenway.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1164604377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3565 ELKER RD",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9961 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92335",
            "telephone_number": "909-427-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTHRA",
        "first_name": "SHEETAL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A9625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.