NPIMap

Organization Active NPI

Vinod C. Patwardhan MD

  • Clinical Medical Laboratory
  • Upland, CA
National Provider Identifier
1396016010
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
LAB64832F Issued in CA
Legal business name
VINOD C. PATWARDHAN MD
Practice address
918 W Foothill Blvd
Suite B
Upland, CA 91786-3772
Phone
(909) 949-4435
Fax
(909) 982-4436
NPI assigned
Jan 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Authorized official

Name
Vinod C Patwardhan, MDNPI 1114922606
Title
Owner/Director
Phone
(909) 949-4435

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
Clinical Medical Laboratory 291U00000X LAB64832F CA Primary

Addresses

Primary practice location

918 W Foothill Blvd
Suite B
Upland, CA 91786-3772

Mailing address

918 W Foothill Blvd
Suite B
Upland, CA 91786-3772
Phone (909) 949-4435

Other identifiers 3

IdentifierTypeStateIssuer
LAB64832FMedicaidCA
CLM00302177OtherCACLINICAL LABORATORY LICENSE
05D0564832OtherCACLIA ID

National Provider Directory

National Provider Directory

Locations

918 W Foothill Blvd
Ste B
Upland, CA 91786
Phone (909) 949-4435

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": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327536000000",
    "number": "1396016010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 W FOOTHILL BLVD",
            "address_2": "SUITE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863772",
            "telephone_number": "909-949-4435",
            "fax_number": "909-982-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 W FOOTHILL BLVD",
            "address_2": "SUITE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863772",
            "telephone_number": "909-949-4435",
            "fax_number": "909-982-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINOD C. PATWARDHAN MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2012-01-26",
        "status": "A",
        "authorized_official_last_name": "PATWARDHAN",
        "authorized_official_first_name": "VINOD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "909-949-4435",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "LAB64832F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB64832F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL LABORATORY LICENSE",
            "identifier": "CLM00302177",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA  ID",
            "identifier": "05D0564832",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.