Bendito Medical Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BENDITO MEDICAL CORPORATION

Practice address

1780 E Highland Ave
San Bernardino, CA 92404-4618

Phone

(909) 402-4601

Fax

(909) 402-4609

NPI assigned

Mar 26, 2020

Organization subpart

No

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

Authorized official

Name

Chioma Kalu, MDNPI 1336387018

Title

MD/Ceo

Phone

(909) 402-4601

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Chioma Anuli Kalu, M.D.

  • Pediatrics Physician
  • Canoga Park, CA
  • NPI 1336387018
  Medicare reassignment Care Compare group NPD Authorized official
• Fred M Watkins, M.D.

  • Family Medicine Physician
  • Corona, CA
  • NPI 1417244591
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1679100911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 E HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044618",
            "telephone_number": "818-618-3728",
            "fax_number": "818-888-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 E HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044618",
            "telephone_number": "909-402-4601",
            "fax_number": "909-402-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENDITO MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A",
        "authorized_official_last_name": "KALU",
        "authorized_official_first_name": "CHIOMA",
        "authorized_official_title_or_position": "MD/CEO",
        "authorized_official_telephone_number": "909-402-4601",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrinamay Belmonte
• Karence Belton
• Alejandro Beltran Jr.
• Jackelyn Beltran
• Florestina Bench, RN
• Esther Benedict, NP
• Phoebe Marie Benedict
• Benevolence Industries Incorporated
• Benevolence Industries Incorporated
• Emalie Guadalupe Benitez

• Primary Care Clinic/Center in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.