Active NPI
Pierre Ujkic, D.O
- Family Medicine Physician
- Pomona, CA
National Provider Identifier
1497705867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A7747
- Practice address
- 1798 North Garey Avenue
Pomona, CA 91767 - Phone
- (909) 865-9600
- NPI assigned
- May 10, 2006
- Last updated
- Jan 25, 2008
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A7747 | CA | Primary |
Addresses
Primary practice location
1798 North Garey Avenue
Pomona, CA 91767
Mailing address
2100 Powell Street Ste 920
Emeryville, CA 94608-1803
Phone (510) 350-2777
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX77470 | Medicaid | CA | |
| 112295 | Medicaid | AZ |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A7747 | CA | MD | Family Medicine Physician |
| 4427 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201219200000",
"number": "1497705867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL STREET STE 920",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081803",
"telephone_number": "510-350-2777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1798 NORTH GAREY AVENUE",
"city": "POMONA",
"state": "CA",
"postal_code": "91767",
"telephone_number": "909-865-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UJKIC",
"first_name": "PIERRE",
"credential": "D.O",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2008-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A7747",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX77470",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112295",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.