Sergio Nathaniel Avila, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60689 Issued in CA

Practice address

790 E Bonita Ave FL 2
Pomona, CA 91767-1906

Phone

(909) 447-8585

Fax

(909) 447-8593

NPI assigned

Dec 20, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chaparral Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Pomona, CA
  • NPI 1477733624
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1396405312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550",
            "fax_number": "909-398-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 E BONITA AVE FL 2",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671906",
            "telephone_number": "909-447-8585",
            "fax_number": "909-447-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "SERGIO",
        "middle_name": "NATHANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-20",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Avellaneda
• Peyton Avery
• Ernest Avila
• Frances Avila
• Samantha Avila
• Sonia Avila
• Kathia Sofia Aviles
• Moises Rey Avina
• Awad and Moore Dental Corporation
• Moller Awad, DMD

• Physician Assistant in Pomona, CA
• Providers in Pomona, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.