Active NPI
Montclair Community Health Center
- Family Medicine Physician
- Montclair, CA
National Provider Identifier
1508373119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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 ALLIANCE
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407306772 | Medicaid | CA |
National Provider Directory
National Provider Directory- Tax ID family
- Health Service Alliance
- 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.
-
- Family Medicine Physician
- Palm Desert, CA
- NPI 1568197408
-
- Family Medicine Physician
- Hesperia, CA
- NPI 1689492167
-
- Family Medicine Physician
- Rancho Cucamonga, CA
- NPI 1861181216
-
- Family Medicine Physician
- Rancho Cucamonga, CA
- NPI 1922687466
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.