Organization Active NPI

Montclair Community Health Center

  • Family Medicine Physician
  • Montclair, CA
National Provider Identifier
1508373119
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MONTCLAIR COMMUNITY HEALTH CENTER
Practice address
5050 San Bernardino St
Montclair, CA 91763-2326
Phone
(909) 281-5800
Fax
(909) 281-5858
NPI assigned
Jan 4, 2018
Organization subpart
Yes
Parent organization
HEALTH SERVICE ALLIANCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
James Lally, DO
Title
Cmo
Phone
(909) 281-5800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5050 San Bernardino St
Montclair, CA 91763-2326

Mailing address

5050 San Bernardino St
Montclair, CA 91763-2326
Phone (909) 281-5800

Other practice location 1

4651 Holt Blvd Ste G
Montclair, CA 91763-4730
Phone (909) 326-0414

Other identifiers 1

IdentifierTypeStateIssuer
1407306772MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Health Service Alliance5 organizations share this tax ID, including this one
Part of
Health Service Alliance

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1508373119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SAN BERNARDINO ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632326",
            "telephone_number": "909-281-5800",
            "fax_number": "909-281-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SAN BERNARDINO ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632326",
            "telephone_number": "909-281-5800",
            "fax_number": "909-281-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4651 Holt Blvd Ste G",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "CA",
            "postal_code": "917634730",
            "country_code": "US",
            "telephone_number": "909-326-0414",
            "fax_number": "909-326-0415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MONTCLAIR COMMUNITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH SERVICE ALLIANCE",
        "enumeration_date": "2018-01-04",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A",
        "authorized_official_last_name": "LALLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "909-281-5800",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407306772",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.