Clinica Medica Centro Laser Hispano Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A32553 Issued in CA

Legal business name

CLINICA MEDICA CENTRO LASER HISPANO INC.

Practice address

1341 E 4TH St
Unit B
Ontario, CA 91764-3034

Phone

(909) 467-1445

Fax

(909) 467-1446

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Marc Rifkin, MA

Title

Director

Phone

(909) 467-1445

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Victor Manuel Campos, FNP

  • Nurse Practitioner
  • Upland, CA
  • NPI 1710034350
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174658322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 E 4TH ST",
            "address_2": "UNIT B",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917643034",
            "telephone_number": "909-467-1445",
            "fax_number": "909-467-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 E 4TH ST",
            "address_2": "UNIT B",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917643034",
            "telephone_number": "909-467-1445",
            "fax_number": "909-467-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MEDICA CENTRO LASER HISPANO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIFKIN",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "909-467-1445",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A32553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00A325530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Clelland
• Herryanson Clifford
• Clinica Dental Familiar Ontario
• Clinica Dental Familiar San Judas Tadeo
• Clinica Dental Integral
• CMS Medical Biling
• Daniel Cobarrubias
• Camille Cobb
• Nicole Cochrane
• Carter Coggins

• General Practice Physician in Ontario, CA
• Providers in Ontario, CA by specialty
• General Practice Physician in California

• 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.