NPIMap

Organization Active NPI

Sierra Pacific Pediatric Associates

  • Pediatrics Physician
  • Fontana, CA
National Provider Identifier
1457544454
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A86339 Issued in CA
Legal business name
SIERRA PACIFIC PEDIATRIC ASSOCIATES
Practice address
16465 Sierra Lakes Pkwy Ste 245
Fontana, CA 92336-1242
Phone
(909) 829-7337
Fax
(909) 829-1218
NPI assigned
Aug 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Dr. Richard ChangNPI 1831195882
Title
MD
Phone
(909) 829-7337

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A86339 CA Primary

Addresses

Primary practice location

16465 Sierra Lakes Pkwy Ste 245
Fontana, CA 92336-1242

Mailing address

16465 Sierra Lakes Pkwy Ste 245
Fontana, CA 92336-1242
Phone (909) 829-7337

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1457544454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY STE 245",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-829-7337",
            "fax_number": "909-829-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY STE 245",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-829-7337",
            "fax_number": "909-829-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA PACIFIC PEDIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "909-829-7337",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A86339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.