MONTCLAIR VIDA HEALTH CLINIC PC (NPI# 1699034827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699034827 |
| Entity Type | Organization |
| Organization Name | MONTCLAIR VIDA HEALTH CLINIC PC |
| Practice Address |
5404 Moreno St Suite N&p Montclair CA 91763 |
| Mailing Address |
5404 Moreno St Suite N&p Montclair CA 91763-1667 |
| Practice Telephone | 9099494400 |
| Practice Fax Number | 9099494441 |
| Mailing Telephone | 9099494400 |
| Mailing Fax Number | 9099494441 |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2018-06-07 |
| Authorized Official Name | GINGER L LEON (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9099494400 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
20A8311 | CA | Ambulatory Health Care Facilities |
| Street Address |
5404 MORENO ST SUITE N&P |
| City | MONTCLAIR |
| State | CA |
| Zip Code | 91763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245234780 | Ginger Lina Leon | Family Medicine | 5404 Moreno St, Ste. N, Montclair, CA 91763-1667 | 2005-06-13 |
| 1588016364 | Leon Forefront Medical Services Inc. | Family Medicine | 5404 Moreno St, Montclair, CA 91763-1667 | 2016-07-06 |
| 1043371636 | Martin Madrigal | Physician Assistant | 5404 Moreno St, Suite N, Montclair, CA 91763-1667 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194335760 | Cho Jeon Yun Dental Partnership | Dentist | 9655 Monte Vista Ave #406, Montclair, CA 91763 | 2020-08-07 |
| 1215498811 | Above Urgent Care Center | Emergency Medicine | 8891 N. Central Ave Ste A, Montclair, CA 91763 | 2019-03-27 |
| 1467936906 | Bronislava Kroulik | Behavior Technician | 4950 San Bernardino St Ste 101, Montclair, CA 91763 | 2018-09-20 |
| 1063936110 | Monique Karina Enriquez | Licensed Vocational Nurse | 5580 Moreno St #82, Montclair, CA 91763 | 2017-07-31 |
| 1972961159 | Lacy Pinsky | Specialist/Technologist | 5035 Flora St., Montclair, CA 91763 | 2016-02-03 |
| 1912333790 | Cinta Hospice Care Inc | Hospice Care, Community Based | 5050 Palo Verde Street, Suite 101, Montclair, CA 91763 | 2013-09-24 |
| 1720334626 | Priority One Hospice, Inc. | Hospice Care, Community Based | 4959 Palo Verde St Ste 107c, Montclair, CA 91763 | 2012-07-28 |
| 1689982498 | Paulina Trujillo Perez | Counselor | 9916 Central Ave., Montclair, CA 91763 | 2010-09-15 |
| 1982846499 | Esther Phillips Agepogu | Physician Assistant | 9301 Central Ave., Montclair, CA 91763 | 2009-03-30 |
| 1568633139 | Mahin Nosrati-jahromi | Dentist | 9509 Central Ave #d, Montclair, CA 91763 | 2008-03-21 |
| Find all providers in zip 91763 | ||||
| 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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|---|---|---|---|---|
| 1114116472 | Healthy Transitions, LLC | Clinic/Center | 50 Church St. Suite L4, Montclair, NJ 07042 | 2007-10-23 |
| 1558975789 | Wise Health Pro | Clinic/Center | 23 Wheeler St Fl 2, Montclair, NJ 07042-4603 | 2020-09-04 |
| 1407217086 | Compassion Care Home Health Services LLC | Clinic/Center | 69 Alexander Ave, Montclair, NJ 07043-2629 | 2016-03-10 |
| 1457489544 | Monte Vista Child Care Center Inc | Clinic/Center | 9140 Monte Vista Ave, Montclair, CA 91763-1723 | 2007-03-01 |
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| 1811517832 | D.e. Garrison, D.o., Inc. | Clinic/Center | 3209 Esplanade Ste 120, Chico, CA 95973-0154 | 2020-04-20 |
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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.