Organization Active NPI

Ambulatory Pacemaker Clinic Inc

  • Cardiology Technician
  • Rancho Cucamonga, CA
National Provider Identifier
1386856292
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiology TechnicianTaxonomy code 246W00000X
Legal business name
AMBULATORY PACEMAKER CLINIC INC
Practice address
7678 Zircon Ave
Rancho Cucamonga, CA 91730
Phone
(909) 982-9121
Fax
(909) 982-9011
NPI assigned
May 4, 2007
Last updated
Oct 31, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Authorized official

Name
Mrs. Dimitri Hunter
Title
Ceo
Phone
(909) 982-9121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiology Technician 246W00000X CA Primary

Addresses

Primary practice location

7678 Zircon Ave
Rancho Cucamonga, CA 91730

Mailing address

7678 Zircon Ave
Rancho Cucamonga, CA 91730-2026
Phone (909) 982-9121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050830001062 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6507897485 Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

Locations

388 E Foothill Blvd
Upland, CA 91786
Phone (909) 982-9121

Practitioners & affiliated clinicians

Practitioners 1

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": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477872000000",
    "number": "1386856292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7678 ZIRCON AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917302026",
            "telephone_number": "909-982-9121",
            "fax_number": "909-982-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7678 ZIRCON AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91730",
            "telephone_number": "909-982-9121",
            "fax_number": "909-982-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY PACEMAKER CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2016-10-31",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "DIMITRI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-982-9121",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "246W00000X",
            "taxonomy_group": "",
            "desc": "Technician, Cardiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.