Individual provider Active NPI

Victor L Pappoe, MD

  • Nephrology Physician
  • Pomona, CA
National Provider Identifier
1396781969
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G46207 Issued in CA
Practice address
1900 Royalty Dr
Suite 130
Pomona, CA 91767-3032
Phone
(909) 623-1561
Fax
(909) 623-1100
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G46207 CA Primary

Addresses

Primary practice location

1900 Royalty Dr
Suite 130
Pomona, CA 91767-3032

Mailing address

1900 Royalty Dr
Suite 130
Pomona, CA 91767-3032
Phone (909) 623-1561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46207CAMDMental Health Counselor
G46207CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hygeia Medical Group, Inc. Nephrology PastSince Aug 15, 2006 Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1396781969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 ROYALTY DR",
            "address_2": "SUITE 130",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673032",
            "telephone_number": "909-623-1561",
            "fax_number": "909-623-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ROYALTY DR",
            "address_2": "SUITE 130",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673032",
            "telephone_number": "909-623-1561",
            "fax_number": "909-623-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPOE",
        "first_name": "VICTOR",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G46207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.