NPIMap

Organization Active NPI

Western University of Health Sciences

  • Family Medicine Physician
  • Pomona, CA
National Provider Identifier
1679515217
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WESTERN UNIVERSITY OF HEALTH SCIENCES
Practice address
795 E Second Street
Suite 5
Pomona, CA 91766-2007
Phone
(909) 865-2565
Fax
(909) 865-2955
NPI assigned
Jun 11, 2006
Organization subpart
Yes
Parent organization
WESTERN UNIVERSITY OF HEALTH SCIENCESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Amy Padoongpatt
Title
Senior Director of Operations
Phone
(909) 865-2565

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Neuromusculoskeletal Medicine & OMM PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204D00000X CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X CA Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X CA
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X CA
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X CA
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X CA
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X CA
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X CA

Addresses

Primary practice location

795 E Second Street
Suite 5
Pomona, CA 91766-2007

Mailing address

795 E Second Street
Suite 5
Pomona, CA 91766-2007
Phone (909) 865-2565

Other identifiers 1

IdentifierTypeStateIssuer
GR0077980MedicaidCA

Other names 1

  • WesternU Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050728000981 CA Part B Supplier - Clinic/Group Practice 0648208991 Receives reassigned benefits from 83 practitioners
4 other NPIs on this enrollment
Practice locations: Pomona, CA; Moreno Valley, CA; Montclair, CA; Los Angeles, CA; Colton, CA; Chino, CA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Cornerstone Progressive

Locations

26520 Cactus Ave
Ste M2072
Moreno Valley, CA 92555

795 E 2nd St
Ste 57
Pomona, CA 91766

795 E 2nd St
Ste 555
Pomona, CA 91766

887 E 2nd St
Ste C
Pomona, CA 91766
Phone (909) 865-2565

795 E 2nd St
Pomona, CA 91766
Phone (909) 706-3730

795 E 2nd St
Ste 5
Pomona, CA 91766
Phone (909) 706-3877

8112 Milliken Ave
Ste 2012
Rancho Cucamonga, CA 91730

8686 Haven Ave
Ste 600
Rancho Cucamonga, CA 91730

8686 Haven Ave
Ste 200
Rancho Cucamonga, CA 91730
Phone (909) 706-3950

8112 Milliken Ave
Ste 101-2
Rch Cucamonga, CA 91730
Phone (909) 706-3950

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 93

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

View all 93

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1679515217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 E SECOND STREET",
            "address_2": "SUITE 5",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-865-2565",
            "fax_number": "909-865-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 E SECOND STREET",
            "address_2": "SUITE 5",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-865-2565",
            "fax_number": "909-865-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN UNIVERSITY OF HEALTH SCIENCES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN UNIVERSITY OF HEALTH SCIENCES",
        "enumeration_date": "2006-06-11",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "PADOONGPATT",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "909-865-2565"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0077980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WesternU Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.