Individual provider Active NPI

Robert Cole, MD

  • Pediatrics Physician
  • Fontana, CA
National Provider Identifier
1447742333
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A164208 Issued in CA
Practice address
8110 Mango Ave Ste 104
Fontana, CA 92335-3603
Phone
(909) 427-1303
NPI assigned
Jun 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A164208 CA Primary

Addresses

Primary practice location

8110 Mango Ave Ste 104
Fontana, CA 92335-3603

Mailing address

PO Box 12209
San Bernardino, CA 92423-2209
Phone (909) 335-4188

Other practice location 1

11234 Anderson St
Loma Linda, CA 92350-1716
Phone (909) 558-4174

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210914000671 CA Practitioner - Pediatric Medicine 6103222369 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A164208CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Medical Group, Inc Pediatrics CurrentSince Aug 9, 2021 Accepting new patients
Pinnacle Medical Group, Inc Pediatrics CurrentSince Aug 9, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 10, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 10, 2025 Accepting new patients
Pinnacle Medical Group, Inc. Pediatrics PastSince Aug 29, 2021 Accepting new patients

Locations

8110 Mango Ave
Fontana, CA 92335
Phone (909) 427-1303

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

8110 Mango Ave
Ste 104
Fontana, CA 92335
Phone (909) 427-1303

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

10431 Lemon Ave
Ste N
Rch Cucamonga, CA 91737
Phone (909) 466-6579

Organizations & group practices 6

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": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1447742333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12209",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924232209",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 MANGO AVE STE 104",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353603",
            "telephone_number": "909-427-1303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923501716",
            "country_code": "US",
            "telephone_number": "909-558-4174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2025-05-27",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A164208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.