Individual provider Active NPI

Chioma Enweasor, M.D

  • Pediatrics Physician
  • Fontana, CA
National Provider Identifier
1184078099
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A151014 Issued in CA
Practice address
15290 Summit Ave Ste B
Fontana, CA 92336-0240
Phone
(909) 225-1900
Fax
(909) 663-9072
NPI assigned
Apr 17, 2016
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X A151014 CA
Pediatrics Physician 208000000X A151014 CA Primary

Addresses

Primary practice location

15290 Summit Ave Ste B
Fontana, CA 92336-0240

Mailing address

15290 Summit Ave Ste B
Fontana, CA 92336-0240
Phone (909) 225-1900

Other practice location 1

11175 Campus Street Coleman Pavillion A1111
Loma Linda, CA 92350-0001
Phone (909) 558-0440

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
I20210817003436 CA Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 5092055806 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A151014CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
County of Riverside CurrentSince May 1, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
County of Riverside CurrentSince May 1, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Goldstar Pediatrics PC Pediatrics PastSince Dec 26, 2021 Accepting new patients
Kwabena Osei, MD. Inc Allergy & Immunology PastSince Dec 21, 2025 Accepting new patients

Locations

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

11234 Anderson St
Ofc
Loma Linda, CA 92350
Phone (909) 558-4074

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

11401 Heacock St
Ste 330
Moreno Valley, CA 92557
Phone (951) 247-8697

26600 Cactus Ave
Ste 300
Moreno Valley, CA 92555
Phone (800) 720-9553

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

Interoperability endpoints

  • Direct secure messaging: cenweasor94811@direct.llu.edu

Organizations & group practices 12

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": "1460851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1184078099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15290 SUMMIT AVE STE B",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360240",
            "telephone_number": "909-225-1900",
            "fax_number": "909-663-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15290 SUMMIT AVE STE B",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360240",
            "telephone_number": "909-225-1900",
            "fax_number": "909-663-9072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11175 Campus Street Coleman Pavillion A1111",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923500001",
            "country_code": "US",
            "telephone_number": "909-558-0440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENWEASOR",
        "first_name": "CHIOMA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-17",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A151014",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A151014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.