Active NPI
Joseph Richard Omaghomi
- Durable Medical Equipment & Medical Supplies
- San Bernardino, CA
National Provider Identifier
1629212444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 50768
- Practice address
- 1988 N D St
San Bernardino, CA 92405-3912 - Phone
- (909) 886-5209
- Fax
- (909) 886-5235
- NPI assigned
- Apr 23, 2009
- Last updated
- Apr 23, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 50768 | CA | Primary |
Addresses
Primary practice location
1988 N D St
San Bernardino, CA 92405-3912
Mailing address
1988 N D St
San Bernardino, CA 92405-3912
Phone (909) 886-5209
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50768 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240444800000",
"number": "1629212444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1988 N D ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924053912",
"telephone_number": "909-886-5209",
"fax_number": "909-886-5235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1988 N D ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924053912",
"telephone_number": "909-886-5209",
"fax_number": "909-886-5235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMAGHOMI",
"first_name": "JOSEPH",
"middle_name": "RICHARD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-23",
"last_updated": "2009-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "CA",
"license": "50768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.