SWAPNA S. KUDTARKAR (NPI# 1104939172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104939172 |
| Entity Type | Individual |
| Full Name | SWAPNA S. KUDTARKAR |
| Credential | M.D. |
| Practice Address |
17051 Sierra Lakes Pkwy Ste 101 Fontana CA 92336-1274 |
| Mailing Address |
Po Box 10488 San Bernardino CA 92423-0488 |
| Practice Telephone | 9094282040 |
| Practice Fax Number | 9094282191 |
| Mailing Telephone | 9094282040 |
| Mailing Fax Number | 9094282191 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2011-09-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | A067887 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1104939172 | 05 | |
| CA | BLUE SHIELD OF CA | ZZZ39356Z | 01 |
| Street Address |
17051 SIERRA LAKES PKWY STE 101 |
| City | FONTANA |
| State | CA |
| Zip Code | 92336-1274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780226852 | Dignity Health Medical Foundation | Clinic/Center | 17051 Sierra Lakes Pkwy Ste 101, Fontana, CA 92336-1274 | 2019-10-10 |
| 1578082939 | Karla Anais Taborga | Nurse Practitioner | 17051 Sierra Lakes Pkwy Ste 101, Fontana, CA 92336-1274 | 2017-09-15 |
| 1265886196 | Felipe Orlando Camero Amortegui | Pediatrics | 17051 Sierra Lakes Pkwy Ste 101, Fontana, CA 92336-1274 | 2016-04-18 |
| 1033472741 | Miguel Angel Martinez | Family Medicine | 17051 Sierra Lakes Pkwy Ste 101, Fontana, CA 92336-1274 | 2012-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700361243 | Schmidt and Jefferson Dental Corporation | Dentist | 16944 South Highland Avenue, Ste. 400, Fontana, CA 92336 | 2018-10-01 |
| 1275032658 | Kenitha Pulliam | Behavioral Analyst | 14051 Catalina Ct, Fontana, CA 92336 | 2018-02-12 |
| 1568961183 | Jordan Frailey | Marriage & Family Therapist | 9161 Sierra Ave. Suite 213, Fontana, CA 92336 | 2018-02-09 |
| 1689198905 | Sara Alyssa Lynch | Specialist/Technologist | 7151 Oak Tree Place, Fontana, CA 92336 | 2017-07-28 |
| 1043749526 | Eric Ceasar Parian Lopez | Registered Nurse | 16001 Pfc Paris Montanez Dr., Fontana, CA 92336 | 2017-06-08 |
| 1275065393 | Alyssa Calderon | Marriage & Family Therapist | 14335 Quail Ct, Fontana, CA 92336 | 2017-03-29 |
| 1588029219 | Daisy Maritza Santana | Behavioral Analyst | 16320 Rosa Linda Ln, Fontana, CA 92336 | 2015-12-23 |
| 1407237498 | Natalie Kathleen Herrera | Physician Assistant | 16456 Sierra Lakes Pkwy, Suite 300, Fontana, CA 92336 | 2015-06-15 |
| 1255738241 | Southern California Picc Providers, Inc. | Spec/Tech, Cardiovascular | 5787 Little Shay Dr, Fontana, CA 92336 | 2014-11-19 |
| 1396175758 | Martha C Ajca | Physician Assistant | 17051 Sierra Lakes Parkway, Suite 101, Fontana, CA 92336 | 2013-11-22 |
| Find all providers in zip 92336 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598025058 | Kimberly T. Ho | Pediatrics | 16465 Sierra Lakes Pkwy Ste 250, Fontana, CA 92336-1262 | 2012-05-17 |
| 1841599933 | Kelly Vasant Sidhpura | Pediatrics | 9985 Sierra Ave Fl Mob22, Fontana, CA 92335 | 2011-03-15 |
| 1457544454 | Sierra Pacific Pediatric Associates | Pediatrics | 16465 Sierra Lakes Pkwy Ste 245, Fontana, CA 92336-1242 | 2007-08-22 |
| 1578613949 | Eduardo Santos Uy | Pediatrics | 9717 Sierra Ave, Fontana, CA 92335-6716 | 2007-01-10 |
| 1255429585 | Marguerite Rindge Cox | Pediatrics | 17577 Arrow Blvd., Fontana, CA 92335 | 2006-10-11 |
| 1295781946 | Leticia M. Cadiz | Pediatrics | 16655 Foothill Blvd, Suite 100, Fontana, CA 92335-8416 | 2006-05-25 |
| 1831195882 | Richard C Chang | Pediatrics | 16465 Sierra Parkway, # 245, Fontana, CA 92236 | 2005-06-23 |
| 1790201283 | Adriana Cornejo | Pediatrics | 16465 Sierra Lakes Pkwy, Fontana, CA 92336-1242 | 2017-08-17 |
| 1265886196 | Felipe Orlando Camero Amortegui | Pediatrics | 17051 Sierra Lakes Pkwy Ste 101, Fontana, CA 92336-1274 | 2016-04-18 |
| 1144682345 | Emmeline See-wai Wong Qin | Pediatrics | 9985 Sierra Ave, Fontana, CA 92335-6720 | 2016-03-25 |
| Find all providers in FONTANA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.