Organization Active NPI

Divine Electrolysis LLC

  • Specialist
  • Ontario, CA
National Provider Identifier
1710509146
Registry record updated Sep 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DIVINE ELECTROLYSIS LLC
Doing business as
Divine Electrolysis
Practice address
1525 S Grove Ave Ste 2
Ontario, CA 91761-4587
Phone
(951) 215-6065
Fax
(909) 752-7205
NPI assigned
May 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2024

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

Authorized official

Name
Araceli GadeaNPI 1558981332
Title
Owner/ Operator
Phone
(909) 952-8279

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1525 S Grove Ave Ste 2
Ontario, CA 91761-4587

Mailing address

2924 E Saint Andrews Dr
Ontario, CA 91761-7549
Phone (909) 952-8279

Other names 1

  • Divine Electrolysis Doing business as

National Provider Directory

National Provider Directory

Locations

11800 Central Ave
Ste 223
Chino, CA 91710
Phone (909) 941-4870

1525 S Grove Ave
Ste 2
Ontario, CA 91761
Phone (951) 215-6065

1525 S Grove Ave
Ste 11
Ontario, CA 91761

111 N Benson Ave
Upland, CA 91786

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": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726358400000",
    "number": "1710509146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 E SAINT ANDREWS DR",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617549",
            "telephone_number": "909-952-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 S GROVE AVE STE 2",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917614587",
            "telephone_number": "951-215-6065",
            "fax_number": "909-752-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE ELECTROLYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2024-09-15",
        "certification_date": "2024-09-15",
        "status": "A",
        "authorized_official_last_name": "GADEA",
        "authorized_official_first_name": "ARACELI",
        "authorized_official_title_or_position": "OWNER/ OPERATOR",
        "authorized_official_telephone_number": "909-952-8279"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Electrolysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2024; 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.