Active NPI
Mark Dalen
- Physician Assistant
- Pomona, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 63245
- Practice address
- 1798 N Garey Ave
Pomona, CA 91767-2918 - Phone
- (909) 865-9500
- NPI assigned
- Jul 10, 2023
- Last updated
- Apr 1, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 63245 | CA | Primary |
Addresses
Primary practice location
1798 N Garey Ave
Pomona, CA 91767-2918
Mailing address
1798 N Garey Ave
Pomona, CA 91767-2918
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63245 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Current | Accepting new patients | |
| Cep America-California | Current | Accepting new patients | |
| Cep America-California | Current | Accepting new patients |
Locations
2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663
1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810
15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
-
- Emergency Medicine Physician
- Delano, CA
- NPI 1598534216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1437837598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1798 N GAREY AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917672918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1798 N GAREY AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917672918",
"telephone_number": "909-865-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALEN",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-10",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "63245",
"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 Apr 1, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.