Active NPI
Max Vinco Soliguen, M.D.
- Pediatrics Physician
- Upland, CA
National Provider Identifier
1700866894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A56150
- Practice address
- 1183 E Foothill Blvd
Suite 230
Upland, CA 91786 - Phone
- (909) 920-9050
- Fax
- (909) 920-9057
- NPI assigned
- Jan 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A56150 | CA | Primary |
Addresses
Primary practice location
1183 E Foothill Blvd
Suite 230
Upland, CA 91786
Mailing address
6246 Indigo Ave
Alta Loma, CA 91701-2551
Phone (909) 466-9160
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A561500 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A56150 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Antonio Regional Hospital | Past | Accepting new patients | |
| Prime Healthcare Services - Montclair, LLC | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Montclair Hopsital Medical Center
- General Acute Care Hospital
- Montclair, CA
- NPI 1992721161
-
- General Acute Care Hospital
- Upland, CA
- NPI 1780681189
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700866894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6246 INDIGO AVE",
"city": "ALTA LOMA",
"state": "CA",
"postal_code": "917012551",
"telephone_number": "909-466-9160",
"fax_number": "909-466-9160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1183 E FOOTHILL BLVD",
"address_2": "SUITE 230",
"city": "UPLAND",
"state": "CA",
"postal_code": "91786",
"telephone_number": "909-920-9050",
"fax_number": "909-920-9057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLIGUEN",
"first_name": "MAX",
"middle_name": "VINCO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A56150",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A561500",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.