Foothills Pain Management Clinic PC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

FOOTHILLS PAIN MANAGEMENT CLINIC PC

Practice address

236 W College St
Covina, CA 91723-1902

Phone

(626) 608-7320

Fax

(626) 608-7322

NPI assigned

Jul 27, 2009

Last updated

Sep 26, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Hetal Mehta

Title

Administrator

Phone

(626) 608-7320

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nelia Bautista Bulos, NP

  • Family Nurse Practitioner
  • West Covina, CA
  • NPI 1528493418
  Medicare reassignment Care Compare group NPD
• Jessica Kuo, MD

  • Pain Medicine (Anesthesiology) Physician
  • Covina, CA
  • NPI 1205465085
  Medicare reassignment Care Compare group NPD
• Dharmesh Mehta, MD

  • Interventional Pain Medicine Physician
  • Covina, CA
  • NPI 1114980760
  Medicare reassignment Care Compare group NPD
• Matthew Hong Gie Tan, MD

  • Anesthesiology Physician
  • Santa Ana, CA
  • NPI 1518527845

  Pain Medicine

  Medicare reassignment Care Compare group NPD
• Joanna Acosta

  • Physician Assistant
  • Covina, CA
  • NPI 1437620283
  Medicare reassignment Care Compare group
• Austin Chang

  • Physician Assistant
  • Covina, CA
  • NPI 1710526983
  Medicare reassignment Care Compare group
• Tanya Lumbangaol

  • Physician Assistant
  • Fontana, CA
  • NPI 1972018513
  Medicare reassignment Care Compare group
• Veronica I Sanchez, L.AC.

  • Family Nurse Practitioner
  • Glendale, CA
  • NPI 1639263551
  Medicare reassignment Care Compare group
• Eric Song, PA-C

  • Physician Assistant
  • Colton, CA
  • NPI 1083918403
  Medicare reassignment Care Compare group
• James Kim, M.D.

  • Interventional Pain Medicine Physician
  • Covina, CA
  • NPI 1649698481

  Single Specialty

  Medicare reassignment NPD
• Katrina Marie Von Kriegenbergh, MD

  • Pain Medicine (Anesthesiology) Physician
  • Torrance, CA
  • NPI 1013270867
  Medicare reassignment NPD
• Harrison Kibe, MD

  • Surgery Physician
  • Boston, MA
  • NPI 1700964814

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1487885372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 209",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917230209",
            "telephone_number": "626-608-7320",
            "fax_number": "626-608-7322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 W COLLEGE ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231902",
            "telephone_number": "626-608-7320",
            "fax_number": "626-608-7322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS PAIN MANAGEMENT CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-27",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "HETAL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-608-7320",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "C52522",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly Sharon Sotto Fontejon, DDS
• Jennifer Marlene Foote-Nalbach, Psy.D., PSY.D.
• Foothill Care Center II, LLC (Calera Home)
• Foothill Care Center II, LLC (Oakbank Home)
• Foothill Family Service
• Jennifer Ford
• Julie Ford
• Dan Foronda
• La'Sonia Marshay Foster
• Shaniqua Foster

• Interventional Pain Medicine Physician in Covina, CA
• Providers in Covina, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.