Mt. Vernon Medical Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

49937 Issued in CA

Legal business name

MT. VERNON MEDICAL CLINIC

Practice address

1023 S Mount Vernon Ave
Colton, CA 92324-4202

Phone

(909) 422-8015

Fax

(909) 422-0625

NPI assigned

Oct 6, 2009

Organization subpart

No

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

Authorized official

Name

Dr. J James Shamloo, M.D.

Title

Owner

Phone

(909) 422-8015

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254787200000",
    "number": "1811222078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 S MOUNT VERNON AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244202",
            "telephone_number": "909-422-8015",
            "fax_number": "909-422-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 S MOUNT VERNON AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244202",
            "telephone_number": "909-422-8015",
            "fax_number": "909-422-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT. VERNON MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-06",
        "last_updated": "2009-10-06",
        "status": "A",
        "authorized_official_last_name": "SHAMLOO",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-422-8015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "49937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rushawn Anthony Moulton
• Michelle Mouri, D.O.
• Siraj Muhammad Mowjood, DO MPH
• Theodoric Moy, PHARM.D.
• Alexis Moyes
• Milton Kenneth Mudge, MD
• Sharon Louise Muhugh-Stockwell
• Jennifer Elaine Mulligan
• Jennifer Shay Mullins, DO
• Justin Kien Mullins, MD

• Clinic/Center in Colton, CA
• Providers in Colton, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; 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.