NPIMap

Organization Active NPI

Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Fontana, CA
National Provider Identifier
1780226852
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
DIGNITY HEALTH MEDICAL FOUNDATION
Doing business as
Dignity Health Medical Network - Inland Empire
Practice address
17051 Sierra Lakes Pkwy Ste 101
Fontana, CA 92336-1274
Phone
(909) 428-2040
Fax
(909) 428-2191
NPI assigned
Oct 10, 2019
Organization subpart
Yes
Parent organization
DIGNITY HEALTH MEDICAL FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Authorized official

Name
Theresa M Hylen
Title
Chief Financial Officer
Phone
(916) 851-2559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

17051 Sierra Lakes Pkwy Ste 101
Fontana, CA 92336-1274

Mailing address

3400 Data Dr FL 3
Rancho Cordova, CA 95670-7956
Phone (888) 314-3627

Other names 1

  • Dignity Health Medical Network - Inland Empire Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Woodland Clinic Med GRP15 organizations share this tax ID, including this one
Part of
Woodland Clinic Med GRP

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1780226852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR FL 3",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956",
            "telephone_number": "888-314-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 SIERRA LAKES PKWY STE 101",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361274",
            "telephone_number": "909-428-2040",
            "fax_number": "909-428-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGNITY HEALTH MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIGNITY HEALTH MEDICAL FOUNDATION",
        "enumeration_date": "2019-10-10",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "HYLEN",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "916-851-2559"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dignity Health Medical Network - Inland Empire",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dignity Health Medical Network - Inland Empire",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.