Pacific Minimally Invasive Surgeons, Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A87866 Issued in CA

Legal business name

PACIFIC MINIMALLY INVASIVE SURGEONS, INC

Practice address

1330 W Covina Blvd
Suite 101
San Dimas, CA 91773-3200

Phone

(909) 599-6784

Fax

(909) 599-7073

NPI assigned

Jul 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Donna E Dudziak, MDNPI 1275630568

Title

President

Phone

(909) 599-6784

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Donna E Dudziak, M.D.

  • Surgery Physician
  • Upland, CA
  • NPI 1275630568
  NPD (past) Authorized official

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1760681043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W COVINA BLVD",
            "address_2": "SUITE 101",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733200",
            "telephone_number": "909-599-6784",
            "fax_number": "909-599-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W COVINA BLVD",
            "address_2": "SUITE 101",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733200",
            "telephone_number": "909-599-6784",
            "fax_number": "909-599-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MINIMALLY INVASIVE SURGEONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "DUDZIAK",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-599-6784",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A87866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECIF",
            "identifier": "8G0894",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monique Ozier
• Frances Irene Pacheco
• Pariss Nicole Pacheco, LVN
• Victor Pacheco
• Pacific Foot and Ankle Associates
• Pacifica Rancho Park LP (West Park Senior Living)
• Nelida Patricia Padron, LCSW
• James V Pagano, MD
• Michelle Palacios, MA, AMFT
• Marissa Palanza

• Surgery Physician in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.

Verify at the official NPI Registry.