Organization Active NPI

Norma Bachoura M D Inc

  • Family Medicine Physician
  • San Dimas, CA
National Provider Identifier
1326210469
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORMA BACHOURA M D INC
Practice address
150 W Foothill Blvd
San Dimas, CA 91773-1102
Phone
(909) 599-9921
Fax
(909) 592-3147
NPI assigned
Mar 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Authorized official

Name
Dr. Norma E Bachoura, M DNPI 1235191131
Title
President
Phone
(909) 599-9921

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

150 W Foothill Blvd
San Dimas, CA 91773-1102

Mailing address

150 W Foothill Blvd
San Dimas, CA 91773-1102
Phone (909) 599-9921

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080521000505 CA Part B Supplier - Clinic/Group Practice 5799854493 Receives reassigned benefits from 2 practitioners
Practice locations: San Dimas, CA

National Provider Directory

National Provider Directory

Locations

150 W Foothill Blvd
Unit B
San Dimas, CA 91773

Practitioners & affiliated clinicians

Practitioners 2

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": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1326210469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W FOOTHILL BLVD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731102",
            "telephone_number": "909-599-9921",
            "fax_number": "909-592-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W FOOTHILL BLVD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731102",
            "telephone_number": "909-599-9921",
            "fax_number": "909-592-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORMA BACHOURA M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "BACHOURA",
        "authorized_official_first_name": "NORMA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-599-9921",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.