Organization Active NPI

Advocate Family Medicine Clinic

  • Family Medicine Physician
  • San Dimas, CA
National Provider Identifier
1366215683
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVOCATE FAMILY MEDICINE CLINIC
Practice address
1330 W Covina Blvd Ste 201
San Dimas, CA 91773-3200
Phone
(626) 999-9118
Fax
(626) 999-9133
NPI assigned
Oct 31, 2023
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Ameerah A Shalikar, MDNPI 1275911315
Title
Ceo
Phone
(951) 238-4749

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 Physician 207Q00000X NU Primary

Addresses

Primary practice location

1330 W Covina Blvd Ste 201
San Dimas, CA 91773-3200

Mailing address

6191 Davidson St
Chino, CA 91710-1126
Phone (951) 238-4749

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240129002331 CA Part B Supplier - Clinic/Group Practice 7719330539 Receives reassigned benefits from 6 practitioners
Practice locations: San Dimas, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2308185Advocate Family Medicine Clinic1330 W Covina Blvd Ste 201, San Dimas, CA 91773Certificate of waiverJul 22, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1366215683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6191 DAVIDSON ST",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917101126",
            "telephone_number": "951-238-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W COVINA BLVD STE 201",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733200",
            "telephone_number": "626-999-9118",
            "fax_number": "626-999-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATE FAMILY MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "SHALIKAR",
        "authorized_official_first_name": "AMEERAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-238-4749",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "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 Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.