Active NPI
Dedrick Aliganga
- Obesity Medicine (Family Medicine) Physician
- San Bernardino, CA
National Provider Identifier
1477287597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obesity Medicine (Family Medicine) Physician
- License
- 95021610
- Practice address
- 401 E Highland Ave Ste 351
San Bernardino, CA 92404-3830 - Phone
- (909) 475-8611
- NPI assigned
- Jul 14, 2022
- Last updated
- Jul 14, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obesity Medicine (Family Medicine) Physician | 207QB0002X | 95021610 | CA | Primary |
Addresses
Primary practice location
401 E Highland Ave Ste 351
San Bernardino, CA 92404-3830
Mailing address
16502 Casa Grande Ave Unit 412
Fontana, CA 92336-6110
Phone (609) 280-9899
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95021610 | CA | MD | Obesity Medicine (Family Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657756800000",
"number": "1477287597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16502 CASA GRANDE AVE UNIT 412",
"city": "FONTANA",
"state": "CA",
"postal_code": "923366110",
"telephone_number": "609-280-9899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 E HIGHLAND AVE STE 351",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924043830",
"telephone_number": "909-475-8611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALIGANGA",
"first_name": "DEDRICK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-14",
"last_updated": "2022-07-14",
"certification_date": "2022-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "207QB0002X",
"taxonomy_group": "",
"desc": "Family Medicine, Obesity Medicine",
"state": "CA",
"license": "95021610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.