Manjot Hundal, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5404 Moreno St Ste G
Montclair, CA 91763-1665

Phone

(909) 949-4400

NPI assigned

Dec 7, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Montclair Vida Health Clinic PC

  • Health Service Clinic/Center
  • Montclair, CA
  • NPI 1699034827
  NPD (past)

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625961600000",
    "number": "1992301832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5404 MORENO ST STE G",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5404 MORENO ST STE G",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631665",
            "telephone_number": "909-949-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNDAL",
        "first_name": "MANJOT",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2021-07-11",
        "certification_date": "2021-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lavette Howard
• Frank J.Y. Hsu, MD
• Alexsandra Huerta
• Erika Huerta
• Ines Huerta
• Sandy Hung, PHARM.D.
• Chase Thomas Hunter
• Jacob Hussey
• Jeremiah Caleb Hutauruk, RPH
• Donette Charissee Hylton- Lumbsden, RN

• Physician Assistant in Montclair, CA
• Providers in Montclair, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2021; 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.