NPIMap

Organization Active NPI

Scott C Lederhaus MD & Lew B Disney MD PRT Lederhaus Scott C Gen PTR

Doing business as Inland Neurosurgery Institute

  • Specialist
  • Pomona, CA
National Provider Identifier
1194826503
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SCOTT C LEDERHAUS MD & LEW B DISNEY MD PRT LEDERHAUS SCOTT C GEN PTR
Doing business as
Inland Neurosurgery Institute
Practice address
255 E Bonita Ave
Building #9
Pomona, CA 91767-1923
Phone
(909) 450-0369
Fax
(909) 450-0366
NPI assigned
Sep 26, 2006
Last updated
Jul 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Authorized official

Name
Anna M Perez
Title
Office Manager
Phone
(909) 450-0369

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

255 E Bonita Ave
Building #9
Pomona, CA 91767-1923

Mailing address

255 E Bonita Ave
Building #9
Pomona, CA 91767-1923
Phone (909) 450-0369

Other practice location 1

1015 N 1st Ave
Arcadia, CA 91006-7401
Phone (909) 450-0369

Other practice location 2

6216 Brockton Ave Ste 213
Riverside, CA 92506-2223
Phone (909) 450-0369

Other identifiers 1

IdentifierTypeStateIssuer
GR0099730MedicaidCA

Other names 1

  • Inland Neurosurgery Institute Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1194826503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE",
            "address_2": "BUILDING #9",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "909-450-0369",
            "fax_number": "909-450-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE",
            "address_2": "BUILDING #9",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "909-450-0369",
            "fax_number": "909-450-0366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 N 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910067401",
            "country_code": "US",
            "telephone_number": "909-450-0369",
            "fax_number": "909-450-0366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6216 Brockton Ave Ste 213",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925062223",
            "country_code": "US",
            "telephone_number": "909-450-0369",
            "fax_number": "909-451-0366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SCOTT C LEDERHAUS MD & LEW B DISNEY MD PRT LEDERHAUS SCOTT C GEN PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2022-07-18",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "909-450-0369"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0099730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inland Neurosurgery Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.