San Dimas Family Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SAN DIMAS FAMILY CLINIC

Practice address

150 W. Foothill Blvd
San Dimas, CA 91773-1102

Phone

(909) 599-9921

Fax

(909) 592-3147

NPI assigned

Apr 19, 2019

Organization subpart

No

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

Authorized official

Name

Clifford Sussman, MDNPI 1033115688

Title

Owner

Phone

(909) 599-9921

Specialties & licenses 1

Addresses

Other names 1

• San Dimas Family Clinic Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Clifford L. Sussman, M.D.

  • Family Medicine Physician
  • San Dimas, CA
  • NPI 1033115688
  NPD (past) Authorized official

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555632000000",
    "number": "1750944286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W. FOOTHILL BLVD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731102",
            "telephone_number": "909-599-9921",
            "fax_number": "909-592-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W. FOOTHILL BLVD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731102",
            "telephone_number": "909-599-9921",
            "fax_number": "909-592-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIMAS FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-19",
        "last_updated": "2019-04-19",
        "status": "A",
        "authorized_official_last_name": "SUSSMAN",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-599-9921",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Dimas Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• San Dimas Emergency Medical Associates Inc.
• San Dimas Family and Sedation Dentistry
• San Dimas Family and Sedation Dentistry
• San Dimas Family Care Inc.
• San Dimas Family Care, a Medical Corporation
• San Dimas Operations, LLC
• San Dimas Pathology Associates
• San Dimas Periodontics
• San Dimas Physical Therapy, Inc
• San Dimas Retirement Center LLC

• Internal Medicine Physician in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.