Organization Active NPI

Allergy and Asthma Specialty Center Inc

  • Allergy & Immunology Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1669845442
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
20A9958 Issued in CA
Legal business name
ALLERGY AND ASTHMA SPECIALTY CENTER INC
Practice address
9220 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730-8551
Phone
(909) 944-9058
NPI assigned
Nov 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Authorized official

Name
Dr. Joshua G Gibbs, DONPI 1427195734
Title
Owner
Phone
(562) 229-4053

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X 20A9958 CA Primary

Addresses

Primary practice location

9220 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730-8551

Mailing address

9220 Haven Ave
Rancho Cucamonga, CA 91730-8551
Phone (909) 944-9058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160414001158 CA Part B Supplier - Clinic/Group Practice 3678871233 Receives reassigned benefits from 1 practitioner
Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

Locations

9220 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 276-4035

9220 Haven Ave
Rancho Cucamonga, CA 91730
Phone (909) 944-9058

9045 Haven Ave
Ste 101
Rch Cucamonga, CA 91730
Phone (909) 944-9058

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1669845442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9220 HAVEN AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308551",
            "telephone_number": "909-944-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 HAVEN AVE",
            "address_2": "STE 101",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308551",
            "telephone_number": "909-944-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY AND ASTHMA SPECIALTY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-03",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-229-4053",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "20A9958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.