Individual provider Active NPI

Smita Malhotra, M.D.

  • Pediatrics Physician
  • Fontana, CA
National Provider Identifier
1649437310
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A106470 Issued in CA
Practice address
17577 Arrow Blvd.
Fontana, CA 92335-4011
Phone
(909) 823-4454
Fax
(909) 823-6918
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A106470 CA Primary

Addresses

Primary practice location

17577 Arrow Blvd.
Fontana, CA 92335-4011

Mailing address

685 Carnegie Dr.
Suite 230
San Bernardino, CA 92408-3583
Phone (909) 890-0407

Other identifiers 1

IdentifierTypeStateIssuer
00A1064700MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090814000474 CA Practitioner - Pediatric Medicine 5799839411 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A106470CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Aug 20, 2025 Accepting new patients
County of Los Angeles Current Accepting new patients
County of Los Angeles CurrentSince Jul 15, 2017 Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Jul 15, 2017 Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Children'S Hospital Los Angeles Past Accepting new patients
Mindful Pediatric Gastroenterology, Inc Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

4650 W Sunset Blvd
#76
Los Angeles, CA 90027
Phone (323) 669-2113

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

Interoperability endpoints

  • Direct secure messaging: smalhotra86346@altamed.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1649437310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 CARNEGIE DR.",
            "address_2": "SUITE 230",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083583",
            "telephone_number": "909-890-0407",
            "fax_number": "909-890-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17577 ARROW BLVD.",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354011",
            "telephone_number": "909-823-4454",
            "fax_number": "909-823-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALHOTRA",
        "first_name": "SMITA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A106470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A1064700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.