PRIME HEALTHCARE SERVICES - MONTCLAIR, LLC (NPI# 1992721161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992721161 |
| Entity Type | Organization |
| Organization Name | PRIME HEALTHCARE SERVICES - MONTCLAIR, LLC |
| Other Organization Name | MONTCLAIR HOPSITAL MEDICAL CENTER |
| Practice Address |
5000 San Bernardino St Montclair CA 91763-2326 |
| Mailing Address |
16850 Bear Valley Rd Victorville CA 92395-5794 |
| Practice Telephone | 9096254111 |
| Mailing Telephone | 7602418222 |
| Mailing Fax Number | 7602418220 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2017-06-28 |
| Authorized Official Name | MR. CHRISTOPHER DOAN (CHIEF COMPLINANCE COUNSEL) |
| Authorized Official Telephone | 9092354307 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| Montclair Hopsital Medical Center | Doing Business As Name - Organization |
| Street Address |
5000 SAN BERNARDINO ST |
| City | MONTCLAIR |
| State | CA |
| Zip Code | 91763-2326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598749921 | Renaissance Radiology Medical Group, Inc. | Radiology | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2005-11-30 |
| 1669961801 | David Nguyen | Student in an Organized Health Care Education/Training Program | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2018-05-03 |
| 1619405875 | Erik Douglas Wiele | General Practice | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2017-05-31 |
| 1174051437 | Nageena Potluri | Family Medicine | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2017-05-31 |
| 1881122315 | Edward Tsung Lin | Family Medicine | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2017-05-29 |
| 1609247683 | Glenn Bryan Morataya | Pharmacist | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2015-10-15 |
| 1639427842 | Montclair Emergency Medical Associates, Inc. | Emergency Medicine | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2012-08-17 |
| 1912041013 | Doctors' Hospital Medical Center of Montclair | General Acute Care Hospital | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2007-02-20 |
| 1316044696 | Montclair Emergency Medical Associates | Emergency Medicine | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2006-09-20 |
| 1396759643 | Minn Soe | Anesthesiology | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2006-07-29 |
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| 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 | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245572627 | Judith Abrams | General Acute Care Hospital | 102 Upper Mountain Ave, Montclair, NJ 07042-1917 | 2013-03-23 |
| 1710298096 | Mountainside Hospital | General Acute Care Hospital | 1 Bay Ave, Montclair, NJ 07042-4837 | 2010-07-01 |
| 1982720249 | Montclair Hospital LLC | General Acute Care Hospital | 1 Bay Avenue, Montclair, NJ 07042-4837 | 2007-03-21 |
| 1912041013 | Doctors' Hospital Medical Center of Montclair | General Acute Care Hospital | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2007-02-20 |
| 1093794695 | Doctors' Hospital Medical Center of Montclair | General Acute Care Hospital | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2006-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437763224 | Mola Medical Practice Inc | General Acute Care Hospital | 6906 Treasure Trl, Los Angeles, CA 90068-1838 | 2020-08-31 |
| 1497376966 | Barton Ambulatory Clinics | General Acute Care Hospital | 2170 South Ave Ste B, South Lake Tahoe, CA 96150-7026 | 2020-05-06 |
| 1346723194 | Eisenhower Medical Center | General Acute Care Hospital | 1401 North Palm Canyon Drive, Suite #202, Palm Springs, CA 92262 | 2018-09-07 |
| 1699282285 | Kern County Hospital Authority | General Acute Care Hospital | 6001 Truxtun Ave Ste 210, Bakersfield, CA 93309-0662 | 2018-01-04 |
| 1598272577 | Eisenhower Medical Center | General Acute Care Hospital | 74020 Alessandro Drive, Suite B, Palm Desert, CA 92260 | 2017-12-29 |
| 1720597511 | Children's Recovery Center 1, LLC | General Acute Care Hospital | 3777 S Bascom Ave, Campbell, CA 95008-7320 | 2017-09-25 |
| 1336668284 | Kern County Hospital Authority | General Acute Care Hospital | 2920 F St Ste B1, Bakersfield, CA 93301-1829 | 2017-09-12 |
| 1821524315 | Azadeh Salek | General Acute Care Hospital | 308 Paseo De La Playa Apt 4, Redondo Beach, CA 90277-6251 | 2017-05-03 |
| 1790210359 | Va Hospital Mather | General Acute Care Hospital | 3131 Sparrow Dr, Sacramento, CA 95834-2639 | 2017-04-20 |
| 1881127041 | Chad William Downing | General Acute Care Hospital | 28003 Via Del Agua, Laguna Niguel, CA 92677-7359 | 2017-04-05 |
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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.