Organization Active NPI

Bbddd, Inc

  • Anesthesiology Physician
  • Rialto, CA
National Provider Identifier
1336722149
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
BBDDD, INC
Practice address
2006 N Riverside Ave Ste C
Rialto, CA 92377-4697
Phone
(909) 644-4033
NPI assigned
Apr 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Authorized official

Name
David Ninan, DONPI 1992893523
Title
Ceo
Phone
(909) 831-1724

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
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

2006 N Riverside Ave Ste C
Rialto, CA 92377-4697

Mailing address

25780 Mission Rd
Loma Linda, CA 92354-2507
Phone (909) 831-1724

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220509002053 CA Part B Supplier - Clinic/Group Practice 8729465935 Receives reassigned benefits from 1 practitioner
Practice locations: Rialto, CA

National Provider Directory

National Provider Directory

Locations

2006 N Riverside Ave
#U
Rialto, CA 92377

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": "1619654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1336722149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25780 MISSION RD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542507",
            "telephone_number": "909-831-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 N RIVERSIDE AVE STE C",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923774697",
            "telephone_number": "909-644-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BBDDD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "NINAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-831-1724",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.