Pomona Valley Medical Group, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

POMONA VALLEY MEDICAL GROUP, INC.

Doing business as

ProMed Health Network

Practice address

4150 E. Concours Street
Suite 100
Ontario, CA 91764-4989

Phone

(909) 932-1045

Fax

(909) 931-5077

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Richard Carpe, C.P.A.

Title

Director of Managed Care Finance

Phone

(909) 932-1045

Specialties & licenses 1

Addresses

Other names 1

• ProMed Health Network Doing business as

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1902903388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 E. CONCOURS STREET",
            "address_2": "SUITE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644989",
            "telephone_number": "909-932-1045",
            "fax_number": "909-931-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 E. CONCOURS STREET",
            "address_2": "SUITE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644989",
            "telephone_number": "909-932-1045",
            "fax_number": "909-931-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POMONA VALLEY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "CARPE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE FINANCE",
        "authorized_official_telephone_number": "909-932-1045",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.P.A."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMed Health Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pomona Community Health Center
• Pomona Community Health Center
• Pomona Community Health Center
• Pomona Community Health Center
• Pomona Community Health Center
• Karen J Pompa
• Angel Eduardo Ponce Jr.
• Ashley Ponce
• Daniella Ponce, HIGH SCHOOL DIPLOMA
• Jennifer Del Real Ponce, LCSW

• Specialist in Ontario, CA
• Providers in Ontario, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.