Individual provider Active NPI

Krishan Malhotra, M.D.

  • Gastroenterology Physician
  • Pomona, CA
National Provider Identifier
1497831978
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A38932 Issued in CA
Practice address
1902 Royalty Dr
Suite 200
Pomona, CA 91767-3030
Phone
(909) 629-2290
Fax
(909) 629-7278
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A38932 CA Primary

Addresses

Primary practice location

1902 Royalty Dr
Suite 200
Pomona, CA 91767-3030

Mailing address

1902 Royalty Dr
Suite 200
Pomona, CA 91767-3030
Phone (909) 629-2290

Other identifiers 1

IdentifierTypeStateIssuer
00A389320MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091217000484 CA Practitioner - GastroenterologyPractitioner - Internal MedicinePractitioner - Hospice/Palliative Care 0941224497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1976
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

550 N Monterey Ave
Ontario, CA 91764-3318
Phone (909) 629-2290

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy189
Upper gastrointestinal (GI) endoscopy for acid reflux224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A38932CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Sun, MD Inc. Current Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Yong Luke Lee Medical Corporation Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Prime Healthcare Services - Montclair, LLC Past Accepting new patients
Primecare Medical Group Past Accepting new patients

Locations

1902 Royalty Dr
Ste 200
Pomona, CA 91767
Phone (909) 629-2290

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497831978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 ROYALTY DR",
            "address_2": "SUITE 200",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673030",
            "telephone_number": "909-629-2290",
            "fax_number": "909-629-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 ROYALTY DR",
            "address_2": "SUITE 200",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673030",
            "telephone_number": "909-629-2290",
            "fax_number": "909-629-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALHOTRA",
        "first_name": "KRISHAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A38932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A389320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.