Individual provider Active NPI

Geeta Jayantilal Patwa, MD

  • Internal Medicine Physician
  • Pomona, CA
National Provider Identifier
1881662278
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A40367 Issued in CA
Practice address
790 East Bonita Ave
2ND Floor
Pomona, CA 91767-1906
Phone
(909) 447-8585
Fax
(909) 447-8593
NPI assigned
Mar 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A40367 CA Primary

Addresses

Primary practice location

790 East Bonita Ave
2ND Floor
Pomona, CA 91767-1906

Mailing address

840 Towne Center Dr
Pomona, CA 91767-5900
Phone (909) 398-1550

Other identifiers 1

IdentifierTypeStateIssuer
00A403670MedicaidCA

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
I20050516000211 CA Practitioner - Internal Medicine 3971544487 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chaparral Medical Group, Inc. Current Accepting new patients
Chaparral Medical Group Inc. CurrentSince May 1, 2005 Accepting new patients
Chaparral Medical Group Inc Internal Medicine CurrentSince May 1, 2005 Accepting new patients

Locations

1801 W Olympic Blvd
Pasadena, CA 91199

840 Towne Center Dr
Pomona, CA 91767

1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767
Phone (909) 623-8796

790 E Bonita Ave
Fl 2
Pomona, CA 91767
Phone (909) 447-8585

10837 Laurel St
Ste 104
Rancho Cucamonga, CA 91730
Phone (909) 581-6732

9190 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 581-6732

Organizations & group practices 3

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1881662278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550",
            "fax_number": "909-398-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 EAST BONITA AVE",
            "address_2": "2ND FLOOR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671906",
            "telephone_number": "909-447-8585",
            "fax_number": "909-447-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATWA",
        "first_name": "GEETA",
        "middle_name": "JAYANTILAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A40367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A403670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.