Individual provider Active NPI

Susana Haydee Zabaneh-Colon, D.O.

  • Family Medicine Physician
  • Pomona, CA
National Provider Identifier
1821179672
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A8604 Issued in CA
Practice address
680 Fairplex Drive
Pomona, CA 91768
Phone
(909) 620-8088
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A8604 CA Primary

Addresses

Primary practice location

680 Fairplex Drive
Pomona, CA 91768

Mailing address

9234 Manzanar Ave
Downey, CA 90240-2808
Phone (562) 869-7395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080130000434 CA Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 4284716218 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A8604CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JWCH Institute Inc CurrentSince Feb 4, 2020 Accepting new patients
JWCH Institute Inc CurrentSince Feb 4, 2020 Accepting new patients
East Valley Community Health Center Past Accepting new patients
East Valley Community Health Center, Inc. Past Accepting new patients

Locations

5650 Jillson St
Commerce, CA 90040
Phone (213) 484-1186

522 S San Pedro St
Los Angeles, CA 90013
Phone (213) 486-4085

12360 Firestone Blvd
Norwalk, CA 90650
Phone (562) 281-0305

Interoperability endpoints

  • Direct secure messaging: susana.zabanehcolonmdl.p1@direct.jwch.nextgenshare.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1821179672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9234 MANZANAR AVE",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902402808",
            "telephone_number": "562-869-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 FAIRPLEX DRIVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "91768",
            "telephone_number": "909-620-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZABANEH-COLON",
        "first_name": "SUSANA",
        "middle_name": "HAYDEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.