NPIMap

Organization Active NPI

Inland Valley Infectious Disease Medical Group

  • Infectious Disease Physician
  • Pomona, CA
National Provider Identifier
1598793531
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
INLAND VALLEY INFECTIOUS DISEASE MEDICAL GROUP
Practice address
255 E Bonita Ave
Pomona, CA 91767-1923
Phone
(760) 740-0799
Fax
(760) 740-0799
NPI assigned
Jun 29, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Daniel P Gluckstein, M.D.NPI 1598703654
Title
President
Phone
(760) 740-0799

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X NU Primary

Addresses

Primary practice location

255 E Bonita Ave
Pomona, CA 91767-1923

Mailing address

PO Box 289007
San Diego, CA 92198-9007
Phone (760) 740-0799

Other identifiers 1

IdentifierTypeStateIssuer
GR0059670MedicaidCA

National Provider Directory

National Provider Directory

Locations

915C W Foothill Blvd
Claremont, CA 91711
Phone (310) 871-6762

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1598793531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 289007",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921989007",
            "telephone_number": "760-740-0799",
            "fax_number": "760-740-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "760-740-0799",
            "fax_number": "760-740-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND VALLEY INFECTIOUS DISEASE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "GLUCKSTEIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-740-0799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0059670",
            "state": "CA"
        }
    ],
    "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 Apr 20, 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.

Verify at the official NPI Registry.