PREMIER FAMILY MEDICINE ASSOCIATES, INC (NPI# 1164668786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164668786 |
| Entity Type | Organization |
| Organization Name | PREMIER FAMILY MEDICINE ASSOCIATES, INC |
| Other Organization Name | PVHC AT CLAREMONT |
| Practice Address |
1601 Monte Vista Ave Suite 100 Claremont CA 91711-2914 |
| Practice Telephone | 9096307938 |
| Practice Fax Number | 9096240560 |
| Mailing Telephone | 9096307938 |
| Mailing Fax Number | 9096240560 |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2014-06-04 |
| Authorized Official Name | DUANE W STYLES (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9096307938 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | PREMIER FAMILY MEDICINE ASSOCIATES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
550000880 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE OF CALIFORNIA CLP | 00320034 | 01 |
| CLIA | 05D0881917 | 01 | |
| CA | DHS LICENSE | 550000880 | 01 |
| CA | GR0083730 | 05 |
| Other Name | Type Code |
|---|---|
| PVHC at Claremont | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912907114 | Premier Family Medicine Associates, Inc | Family Medicine | 1770 N Orange Grove Ave, Suite 101, Pomona, CA 91767-3027 | 2005-07-28 |
| 1033634373 | Premier Family Medicine Associates, Inc | Clinic/Center | 2333 Foothill Blvd, La Verne, CA 91750-3027 | 2017-08-08 |
| 1730112426 | Premier Family Medicine Associates, Inc | Family Medicine | 2140 Grand Ave, Suite 125, Chino Hills, CA 91709-6800 | 2006-07-08 |
| Street Address |
1601 MONTE VISTA AVE SUITE 100 |
| City | CLAREMONT |
| State | CA |
| Zip Code | 91711-2914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417951096 | Robyn Dettmar | Physician Assistant | 1601 Monte Vista Ave, 190, Claremont, CA 91711-2962 | 2005-06-10 |
| 1558863282 | Sylvia Marie Rosales | Licensed Vocational Nurse | 1601 Monte Vista Ave, Claremont, CA 91711-2962 | 2018-03-08 |
| 1912443086 | Thuy Phuong Bach | Physician Assistant | 1601 Monte Vista Ave, Suite 100, Claremont, CA 91711-2962 | 2017-01-13 |
| 1912364969 | Michael Riess Lewin | Psychologist | 1601 Monte Vista Ave, Suite 270, Claremont, CA 91711-2962 | 2016-01-21 |
| 1538562103 | Lauren Kubeck | Physician Assistant | 1601 Monte Vista Ave, Suite 190, Claremont, CA 91711-2962 | 2014-09-26 |
| 1205247855 | Monique Michelle Burleigh Sanchez-castro | Family Medicine | 1601 Monte Vista Ave, Suite 190, Claremont, CA 91711-2962 | 2014-05-16 |
| 1811327356 | Jamie Torres | Physician Assistant | 1601 Monte Vista Ave, Suite 190, Claremont, CA 91711-2962 | 2013-11-20 |
| 1285062901 | Xuan Huynh | Physician Assistant | 1601 Monte Vista Ave, Suite 190, Claremont, CA 91711-2962 | 2013-10-15 |
| 1043654148 | Ah Family Nursing Care Incorporated | Nurse Practitioner | 1601 Monte Vista Ave, Suite 260, Claremont, CA 91711-2962 | 2013-04-19 |
| 1568715282 | Alicia Roth | Physician Assistant | 1601 Monte Vista Ave, Suite 190, Claremont, CA 91711-2962 | 2012-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659919132 | Suzanne Kathryn Wen | Physical Therapist | 224 North Indian Hill Bvld, Claremont, CA 91711 | 2019-12-16 |
| 1336790690 | Angelita M Sherzada | Social Worker | 250 W. First Street, 242, Claremont, CA 91711 | 2019-09-26 |
| 1629560602 | Patricia L Sellers | Marriage & Family Therapist | 220 S Indian Hill Boulevard, Suite E, Claremont, CA 91711 | 2018-06-05 |
| 1477078418 | Geiselia Thomas | Chore Provider | 519 Martin Way, Claremont, CA 91711 | 2017-08-10 |
| 1750804464 | Vasudavan Govindasamy | Speech-Language Pathologist | 1490 North Claremont Blvd Suite 101, Claremont, CA 91711 | 2017-07-25 |
| 1669850103 | Drpaulolivera | Dentist | 450wsanjose, Claremont, CA 91711 | 2015-05-18 |
| 1003204504 | Alexandra Jordan Bandy | Nurse Practitioner | 530 W. Bonita Ave, Claremont, CA 91711 | 2015-01-06 |
| 1437571379 | Susan Clayton Zylstra | Speech-Language Pathologist | 842 Knox Place, Claremont, CA 91711 | 2014-01-13 |
| 1255671053 | Misty Anne Rogers | Acupuncturist | 689 W. Foothill Blvd., Suite D, Claremont, CA 91711 | 2013-02-15 |
| 1629364161 | Lu Tian | Acupuncturist | 250 W. First Street #112, Claremont, CA 91711 | 2011-06-23 |
| Find all providers in zip 91711 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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|---|---|---|---|---|
| 1861752099 | Occupational Health Centers of North Carolina PC | Clinic/Center | 3437 E Main St, Claremont, NC 28610-8672 | 2012-05-22 |
| 1699339044 | Integrative Health Institutes, A Naturopathic Corporation | Clinic/Center | 689 W Foothill Blvd Ste A, Claremont, CA 91711-3400 | 2019-04-30 |
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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.