NPIMap

Organization Active NPI

Kaiser Fontana

  • Special Hospital
  • Fontana, CA
National Provider Identifier
1669889986
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
License
806523 Issued in CA
Legal business name
KAISER FONTANA
Practice address
9961 Sierra Ave
Fontana, CA 92335-6720
Phone
(801) 791-4514
NPI assigned
Jul 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Authorized official

Name
Noc Pham, MDA
Title
Director
Phone
(909) 427-5000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 806523 CA
Special Hospital 284300000X 806523 CA Primary

Addresses

Primary practice location

9961 Sierra Ave
Fontana, CA 92335-6720

Mailing address

1607 Independence Ave
Redlands, CA 92374
Phone (801) 791-4514

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1669889986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 INDEPENDENCE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92374",
            "telephone_number": "801-791-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9961 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356720",
            "telephone_number": "801-791-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FONTANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-18",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "NOC",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "909-427-5000",
        "authorized_official_credential": "MDA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "806523",
            "primary": false
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "CA",
            "license": "806523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.