Robert James Kolesnik, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

G44386 Issued in CA

Practice address

1230 E Arrow Hwy
Upland, CA 91786-4190

Phone

(909) 920-0298

Fax

(909) 985-9227

NPI assigned

Oct 20, 2006

Reactivated

Apr 16, 2008

Last updated

Apr 13, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Robert J. Kolesnik M.D., Inc.

  • Specialist
  • Upland, CA
  • NPI 1639247216
  Authorized official Same address or phone
• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1518067586
  NPD (past)
• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271116800000",
    "number": "1760564256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 E ARROW HWY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864190",
            "telephone_number": "909-920-0298",
            "fax_number": "909-985-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 E ARROW HWY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864190",
            "telephone_number": "909-920-0298",
            "fax_number": "909-985-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLESNIK",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2010-04-13",
        "deactivation_date": "2008-03-11",
        "reactivation_date": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G44386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "G44386",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Knipper
• Ko and Nam DDS a Professional Dental Corporation
• Yohan Ko, L.AC
• Judith A. Koerner, LMFT
• Morris Kokhab, M.D.
• Bhupal Kommineni, MD FACP
• Sean Shukue Kono, D.C.
• Choon Sil Koo, M.D.
• Kopper Imaging
• Nabil Koudsi, MD

• Specialist in Upland, CA
• Providers in Upland, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; 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.