Olha Fomenko, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

A105788 Issued in CA

Practice address

VA Medical Center 11201 Benton St
Loma Linda, CA 92357-0001

Phone

(909) 825-7084

Fax

(909) 796-4508

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1487860896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VA MEDICAL CENTER 11201 BENTON ST",
            "address_2": "ATTN: RESEARCH SERVICE / 151",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923570001",
            "telephone_number": "909-825-7084",
            "fax_number": "909-796-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VA MEDICAL CENTER 11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923570001",
            "telephone_number": "909-825-7084",
            "fax_number": "909-796-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMENKO",
        "first_name": "OLHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A105788",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WI",
            "license": "52909-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Elizabeth Fluitt, PA-C
• Ingrid Fobbs-Mitchell, NP
• Travis Fogel, PHD
• Gregory Scott Foley, PH.D.
• Michael Joseph Foley, AUD
• Kelly Ka-Yee Fong, MD
• Lilly Fong, AGNP-C
• Stephanie Lynn Fong
• Cynthia Lynn Ford, R.D.A
• Josannie Veronica Ford, R.D.A

• Endocrinology, Diabetes & Metabolism Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; 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.

Verify at the official NPI Registry.