BORIS PRUSA (NPI# 1669543583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669543583 |
| Entity Type | Individual |
| Full Name | BORIS PRUSA |
| Credential | MD |
| Practice Address |
9961 Sierra Ave Fontana CA 92335-6720 |
| Practice Telephone | 9094273910 |
| Mailing Telephone | 9094273910 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2008-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | G63074 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
9961 SIERRA AVE |
| City | FONTANA |
| State | CA |
| Zip Code | 92335-6720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578560199 | Barbara Ann Mahoney | Nurse Practitioner | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2005-06-29 |
| 1023629979 | Whitney Mah | Speech-Language Pathologist | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-08-13 |
| 1083224166 | Jennifer Hull | Genetic Counselor, MS | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-08-04 |
| 1568081842 | Jorge Kareem Sierra | Radiologic Technologist | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-04-16 |
| 1821625963 | Syed Sajjad Sarwar Naqvi | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-26 |
| 1730716903 | Hannah Choi | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-26 |
| 1912534413 | Mia Raquel Montoya | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
| 1093342461 | Jennica Kahkejian | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
| 1881221299 | Youstina Youssef | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
| 1790312015 | Sara Tong | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1790312791 | Trevor Nguyen | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd, Building A, Fontana, CA 92335 | 2020-03-27 |
| 1184251365 | Benjamin Chang | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd., Bldg. A, Fontana, CA 92335 | 2020-03-26 |
| 1407487309 | Perla Hernandez | Licensed Vocational Nurse | 14677 Merrill Aver, Fontana, CA 92335 | 2020-01-29 |
| 1013552660 | Valencia Malone | Licensed Vocational Nurse | 14677 Merrill, Fontana, CA 92335 | 2019-11-07 |
| 1831749779 | Daniel Eric Wright | Student in an Organized Health Care Education/Training Program | 14677 Merrell Ave., Fontana, CA 92335 | 2019-09-12 |
| 1962069815 | Melissa Rivera | Licensed Vocational Nurse | 15217 San Bernardino Ave., Fontana, CA 92335 | 2019-05-28 |
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1770147894 | Noelle Chong | Registered Nurse | 14677 Merill Ave, Fontana, CA 92335 | 2019-04-24 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
| Find all providers in zip 92335 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720223845 | Kulwant Singh | Urology | 9661 Sierra Avenue, Fontana, CA 92335 | 2008-12-03 |
| 1467781583 | William Sohn | Urology | 9961 Sierra Ave, Department of Urology, Fontana, CA 92335-6720 | 2009-12-19 |
| 1093911349 | Casey Ki Ng | Urology | 9985 Sierra Ave, Fontana, CA 92335-6720 | 2007-06-25 |
| 1962561563 | Michael A. Lawrence | Urology | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2006-12-08 |
| 1912074758 | Albert Aboelkhair Mikhail | Urology | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2006-11-29 |
| 1114094117 | Luther J. Bryant | Urology | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2006-11-29 |
| 1043387053 | Charles Mark Page | Urology | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2006-11-29 |
| 1215009790 | Yu Wang | Urology | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2006-11-14 |
| 1952472912 | Kent K. Miyamoto | Urology | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2006-11-13 |
| 1417028440 | Michael D. Strub | Urology | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2006-11-13 |
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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.