Organization Active NPI

Dennis a. Chuck M.D. Inc.

  • Ophthalmology Physician
  • Pomona, CA
National Provider Identifier
1225263312
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
DENNIS A. CHUCK M.D. INC.
Practice address
1774 Alameda St
Pomona, CA 91768-1727
Phone
(909) 622-1188
Fax
(909) 623-4768
NPI assigned
May 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Authorized official

Name
Ms. Carmelinda Villa
Title
Medical Biller
Phone
(909) 622-1188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1774 Alameda St
Pomona, CA 91768-1727

Mailing address

1774 Alameda St
Pomona, CA 91768-1727
Phone (909) 622-1188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090723000745 CA Part B Supplier - Clinic/Group Practice 6507918489 Receives reassigned benefits from 1 practitioner
Practice locations: Pomona, CA; Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

Locations

1774 Alameda St
Pomona, CA 91768
Phone (909) 622-1188

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1225263312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 ALAMEDA ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917681727",
            "telephone_number": "909-622-1188",
            "fax_number": "909-623-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 ALAMEDA ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917681727",
            "telephone_number": "909-622-1188",
            "fax_number": "909-623-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS A. CHUCK M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "CARMELINDA",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "909-622-1188",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.