Individual provider Active NPI

Gary Laborada

  • Dental Anesthesiology
  • Pomona, CA
National Provider Identifier
1730733973
Registry record updated Dec 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
License
GA2241 Issued in CA
Practice address
1532 San Bernardino Ave
Pomona, CA 91767-3559
Phone
(760) 245-0151
NPI assigned
Jul 25, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Anesthesiology 1223D0004X GA2241 CA Primary
Dentist 122300000X 104124 CA

Addresses

Primary practice location

1532 San Bernardino Ave
Pomona, CA 91767-3559

Mailing address

13156 Flagstaff Dr
Rancho Cucamonga, CA 91739-9262
Phone (909) 471-3764

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

State licenses

LicenseStateTypeSpecialty
104124CAMDDentist
GA2241CAMDDentist Anesthesiologist

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765065600000",
    "number": "1730733973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13156 FLAGSTAFF DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399262",
            "telephone_number": "909-471-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 SAN BERNARDINO AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673559",
            "telephone_number": "760-245-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABORADA",
        "first_name": "GARY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2025-12-07",
        "certification_date": "2025-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CA",
            "license": "GA2241",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 7, 2025; 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.