Individual provider Active NPI

Lyn Marie Pintelon, DO

  • Family Medicine Physician
  • Riverside, CA
National Provider Identifier
1669467148
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A7308 Issued in CA
Practice address
8990 Garfield St
Ste 6
Riverside, CA 92503-3922
Phone
(951) 358-0784
Fax
(951) 354-7583
NPI assigned
Sep 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A7308 CA Primary

Addresses

Primary practice location

8990 Garfield St
Ste 6
Riverside, CA 92503-3922

Mailing address

8990 Garfield St
Ste 6
Riverside, CA 92503-3922
Phone (951) 358-0784

Other identifiers 1

IdentifierTypeStateIssuer
00AX73080MedicaidCA

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A7308CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1669467148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8990 GARFIELD ST",
            "address_2": "STE 6",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033922",
            "telephone_number": "951-358-0784",
            "fax_number": "951-354-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 GARFIELD ST",
            "address_2": "STE 6",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033922",
            "telephone_number": "951-358-0784",
            "fax_number": "951-354-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINTELON",
        "first_name": "LYN",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX73080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; 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.