NPIMap

Organization Active NPI

Pacific Breast Institute Medical Group

  • Ambulatory Surgical Clinic/Center
  • Pomona, CA
National Provider Identifier
1619380896
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A26396 Issued in CA
Legal business name
PACIFIC BREAST INSTITUTE MEDICAL GROUP
Practice address
350 Vinton Ave
Suite 202
Pomona, CA 91767-3000
Phone
(909) 629-6417
Fax
(909) 629-4755
NPI assigned
Jun 5, 2014
Last updated
Jun 5, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
O D ASCHA,MD APCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Authorized official

Name
Dr. Ossama Deaya Ascha, MDNPI 1659422558
Title
President
Phone
(909) 629-6417

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X A26396 CA Primary

Addresses

Primary practice location

350 Vinton Ave
Suite 202
Pomona, CA 91767-3000

Mailing address

20160 E Limecrest Dr
Covina, CA 91724-3945
Phone (909) 629-6417

Other names 1

  • Cosmetic Surgery Associates Medical Group Other name

National Provider Directory

National Provider Directory
Part of
Ossama D Ascha MD

Practitioners & affiliated clinicians

Practitioners 1

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": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1619380896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20160 E LIMECREST DR",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243945",
            "telephone_number": "909-629-6417",
            "fax_number": "909-629-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 VINTON AVE",
            "address_2": "SUITE 202",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673000",
            "telephone_number": "909-629-6417",
            "fax_number": "909-629-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC BREAST INSTITUTE MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "O D ASCHA,MD APC",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "ASCHA",
        "authorized_official_first_name": "OSSAMA",
        "authorized_official_middle_name": "DEAYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-629-6417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "A26396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cosmetic Surgery Associates Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 5, 2014; 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.