Southwestern Orthopedic Medical Group

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

SOUTHWESTERN ORTHOPEDIC MEDICAL GROUP

Doing business as

Channel Islands Orthopedic Medical Group
Downey Orthopedic Medical Group

Practice address

1 Hidden Hills Cir
Pomona, CA 91766-4821

Phone

(909) 967-3442

Fax

(951) 443-4779

NPI assigned

Jun 19, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Randolph Taylor

Title

Risk Manager

Phone

(909) 967-3442

Specialties & licenses 1

Addresses

Other names 2

• Channel Islands Orthopedic Medical Group Doing business as
• Downey Orthopedic Medical Group Doing business as

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1649700816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HIDDEN HILLS CIR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917664821",
            "telephone_number": "909-967-3442",
            "fax_number": "951-443-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HIDDEN HILLS CIR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917664821",
            "telephone_number": "909-967-3442",
            "fax_number": "951-443-4779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN ORTHOPEDIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_title_or_position": "RISK MANAGER",
        "authorized_official_telephone_number": "909-967-3442"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Channel Islands Orthopedic Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Downey Orthopedic Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Devora Soto, OD
• Melissa Soto
• Vanessa Maria Sotomayor
• Southern California Medical Center, Inc.
• Southside Manor Inc.
• Debora Sparkes
• Trang Huong Sparks, PA
• Specialty Medical
• Specialty Medical LLC
• Jennifer Maureen Speck, M.A.

• Orthopaedic Surgery Physician in Pomona, CA
• Providers in Pomona, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.