Fernando Botero

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

81-4404308 Issued in CA

Practice address

15220 Fox Ridge Dr
Fontana, CA 92336-0230

Phone

(909) 815-0166

NPI assigned

Mar 14, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Inland Care Transport

  • Non-emergency Medical Transport (VAN)
  • Fontana, CA
  • NPI 1154986115
  NPD (past) Authorized official

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1982163465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15220 FOX RIDGE DR",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360230",
            "telephone_number": "909-815-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15220 FOX RIDGE DR",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360230",
            "telephone_number": "909-815-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTERO",
        "first_name": "FERNANDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": "CA",
            "license": "81-4404308",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": "81-4404308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Bonilla
• Sharon Bonilla
• Desiree Cherie Borden, PHARM.D.
• Inelda Borg, OTR
• Heba A. Boshra, M.D.
• Katelyn Bouchard
• Curt L. Bouma, MD
• Keyhaneh Danaee Bouroumand, D.C.
• Cynthia M Bousquet Harris, LCSW
• Levon Dawntise Boutte, LVN

• Non-emergency Medical Transport (VAN) in Fontana, CA
• Providers in Fontana, CA by specialty
• Non-emergency Medical Transport (VAN) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.