LASALLE MEDICAL ASSOCIATES (NPI# 1275661084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275661084 |
| Entity Type | Organization |
| Organization Name | LASALLE MEDICAL ASSOCIATES |
| Practice Address |
17577 Arrow Blvd Fontana CA 92335 |
| Mailing Address |
1855 W Redlands Blvd Fl 2 Redlands CA 92373-3145 |
| Practice Telephone | 9098234454 |
| Practice Fax Number | 9098236918 |
| Mailing Telephone | 9098900407 |
| Mailing Fax Number | 9098904597 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-01-21 |
| Authorized Official Name | ALBERT H. ARTEAGA (CEO/OWNER) |
| Authorized Official Telephone | 9098900407 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0079090 | 05 | |
| CA | MEDI-CAL ID NUMBER | 00A382060 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881150290 | Lasalle Medical Associates | Clinic/Center | 790 E Foothill Blvd # D, Rialto, CA 92376-5269 | 2019-02-11 |
| 1457489197 | Lasalle Medical Associates | Clinic/Center | 31762 Mission Trail, Suite F, Lake Elsinore, CA 92530 | 2007-03-02 |
| 1891892535 | Lasalle Medical Associates | Clinic/Center | 1855 W Redlands Blvd Fl 2, Redlands, CA 92373-3145 | 2006-09-17 |
| 1689130098 | Lasalle Medical Associates | Clinic/Center | 14544 7th St, Victorville, CA 92395-4214 | 2019-02-11 |
| 1023398468 | Lasalle Medical Associates | Preferred Provider Organization | 685 Carnegie Dr, Suite 230, San Bernardino, CA 92408-3502 | 2011-08-17 |
| 1316075062 | Lasalle Medical Associates | Clinic/Center | 16455 Main Street, Suite 1, Hesperia, CA 92345 | 2007-03-02 |
| 1548398142 | Lasalle Medical Associates | Clinic/Center | 1505 W. 17th Street, San Bernardino, CA 92411 | 2007-03-02 |
| 1447388251 | Lasalle Medical Associates | Clinic/Center | 565 N. Mt. Vernon Ave., San Bernardino, CA 92411-2661 | 2007-03-01 |
| Street Address |
17577 ARROW BLVD |
| City | FONTANA |
| State | CA |
| Zip Code | 92335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326132366 | Ftf Pharmacy Corporation | Pharmacy | 17577 Arrow Blvd, Ste 101, Fontana, CA 92335-4011 | 2006-10-03 |
| 1548819634 | Henrietta Anne Green | Physician Assistant | 17577 Arrow Blvd, Fontana, CA 92335-4011 | 2019-09-10 |
| 1912152380 | Kimberly Dennise Madorsky | Physician Assistant | 17577 Arrow Blvd, Fontana, CA 92335-4011 | 2008-11-26 |
| 1477754380 | Cynthia Cheng | Pediatrics | 17577 Arrow Blvd, Fontana, CA 92335-4011 | 2007-05-29 |
| 1780760645 | Halima Tasneem Shahabuddin | Pediatrics | 17577 Arrow Blvd, Fontana, CA 92335 | 2006-10-31 |
| 1225128770 | Yasuhiro Nishiura | Pediatrics | 17577 Arrow Blvd, Fontana, CA 92335 | 2006-10-13 |
| 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 | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
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| 1376926527 | Dignity Health Medical Foundation | Clinic/Center | 17051 Sierra Lakes Pkwy, Suite 101, Fontana, CA 92336-1274 | 2015-07-07 |
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| 1134738032 | Healthworks Med Group of California A Medical Corporation | Clinic/Center | 2821 Scott Blvd Ste 2126, Santa Clara, CA 95050-2549 | 2020-07-27 |
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| Find all providers with the same taxonomy | ||||
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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.