Bernard Colorado

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

29714 Issued in CA

Practice address

1550 N Park Ave
Pomona, CA 91768-1834

Phone

(909) 623-0791

NPI assigned

Mar 11, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Interface Rehab, Inc.

  • Assisted Living Facility
  • Healdsburg, CA
  • NPI 1053178244
  NPD

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1255899019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N PARK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917681834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N PARK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917681834",
            "telephone_number": "909-623-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLORADO",
        "first_name": "BERNARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-11",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "29714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abigail Collavo
• James Collen, MD
• Christina Collier
• Vincent Colocho
• Tamara Elizabeth Colon, MT
• Comfort Care Home Health, Inc.
• Community Education Associates, Inc
• Community Education Associates, Inc
• Community Education Associates, Inc
• Community Speech Center of Upland

• Physical Therapist in Pomona, CA
• Providers in Pomona, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2021; 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.