NPIMap

Organization Active NPI

Central Occupational Medicine Providers - Ontario, a Medical Corporati

  • Occupational Medicine Clinic/Center
  • Ontario, CA
National Provider Identifier
1669730321
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
Legal business name
CENTRAL OCCUPATIONAL MEDICINE PROVIDERS - ONTARIO, A MEDICAL CORPORATI
Practice address
59 S Milliken Ave
Suite 100
Ontario, CA 91761-7811
Phone
(909) 605-8888
Fax
(909) 605-8855
NPI assigned
May 1, 2012
Last updated
Apr 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Authorized official

Name
Mr. Gregory Joseph Speer
Title
Administrator
Phone
(951) 222-2206

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X Primary
Family Medicine Physician 207Q00000X A48324 CA
Family Medicine Physician 207Q00000X 20A5982 CA
Internal Medicine Physician 207R00000X A48512 CA
General Practice Physician 208D00000X G72529 CA
General Practice Physician 208D00000X G70519 CA
General Practice Physician 208D00000X 20A9190 CA

Addresses

Primary practice location

59 S Milliken Ave
Suite 100
Ontario, CA 91761-7811

Mailing address

4300 Central Ave
Riverside, CA 92506-2918
Phone (951) 222-2206

Other names 1

  • COMP Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2161546Central Occupational Medicine Providers59 South Milliken Avenue, Suite 100, Ontario, CA 91761Certificate of waiverFeb 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Central Occupational Medicine Providers - Ontario a Medical Corporati6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

59 S Milliken Ave
Ste 100
Ontario, CA 91761
Phone (909) 605-8888

Practitioners & affiliated clinicians

Practitioners 9

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": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1669730321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 CENTRAL AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062918",
            "telephone_number": "951-222-2206",
            "fax_number": "951-222-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 S MILLIKEN AVE",
            "address_2": "SUITE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617811",
            "telephone_number": "909-605-8888",
            "fax_number": "909-605-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OCCUPATIONAL MEDICINE PROVIDERS - ONTARIO, A MEDICAL CORPORATI",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "SPEER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "951-222-2206",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A48324",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5982",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A48512",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G72529",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G70519",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A9190",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.