DIGNITY HEALTH MEDICAL FOUNDATION (NPI# 1376926527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376926527 |
Entity Type | Organization |
Organization Name | DIGNITY HEALTH MEDICAL FOUNDATION |
Other Organization Name | DIGNITY HEALTH PHYSICIAN NETWORK - INLAND EMPIRE, A SERVICE OF DIGNITY |
Practice Address |
17051 Sierra Lakes Pkwy Suite 101 Fontana CA 92336-1274 |
Mailing Address |
3400 Data Dr Rancho Cordova CA 95670-7956 |
Practice Telephone | 9094282040 |
Practice Fax Number | 9094282191 |
Mailing Telephone | 9168512096 |
Mailing Fax Number | 9168512601 |
Enumeration Date | 2015-07-07 |
Last Update Date | 2015-07-07 |
Authorized Official Name | GEORGE LENZI (CHIEF FINANCIAL OFFICER) |
Authorized Official Telephone | 9168512559 |
Is Organization Subpart | Y |
Parent Organization Name | DIGNITY HEALTH MEDICAL FOUNDATION |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Dignity Health Physician Network - Inland Empire, a service of Dignity | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710129275 | Dignity Health Medical Foundation | Clinic/Center | 105 Dean Way, Folsom, CA 95630-2801 | 2009-03-30 |
1447492905 | Dignity Health Medical Foundation | Clinic/Center | 6060 Watt Ave, North Highlands, CA 95660-4212 | 2009-03-30 |
1366684821 | Dignity Health Medical Foundation | Clinic/Center | 10487 White Rock Rd, Rancho Cordova, CA 95670-5530 | 2009-03-30 |
1558495937 | Dignity Health Medical Foundation | Clinic/Center | 7911 Laguna Blvd, Elk Grove, CA 95758-7920 | 2007-03-15 |
1780226852 | Dignity Health Medical Foundation | Clinic/Center | 17051 Sierra Lakes Pkwy Ste 101, Fontana, CA 92336-1274 | 2019-10-10 |
1568989200 | Dignity Health Medical Foundation | Clinic/Center | 3400 Data Dr, Rancho Cordova, CA 95670-7956 | 2017-08-24 |
1477074474 | Dignity Health Medical Foundation | Clinic/Center | 3400 Data Dr, Rancho Cordova, CA 95670-7956 | 2017-06-29 |
1679019798 | Dignity Health Medical Foundation | Clinic/Center | 6615 Valley Hi Dr, Sacramento, CA 95823-7076 | 2017-01-12 |
1508222647 | Dignity Health Medical Foundation | Clinic/Center | 18406 Roscoe Blvd, Northridge, CA 91325-4107 | 2016-01-05 |
1497180632 | Dignity Health Medical Foundation | Non-Pharmacy Dispensing Site | 1264 Hawks Flight Ct, Suite 100, El Dorado Hills, CA 95762-9348 | 2013-09-06 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | DIGNITY HEALTH MEDICAL FOUNDATION | 3400 Data Dr, Rancho Cordova, CA 95670-7956 |
Street Address |
17051 SIERRA LAKES PKWY SUITE 101 |
City | FONTANA |
State | CA |
Zip Code | 92336-1274 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558422931 | Rabia Manzoor | Pediatrics | 17051 Sierra Lakes Pkwy, Ste 101, Fontana, CA 92336-1274 | 2006-12-12 |
1588907901 | Chester Tung | Family Medicine | 17051 Sierra Lakes Pkwy, Suite 101, Fontana, CA 92336-1274 | 2013-04-03 |
1255612347 | Shi-ying Chang | Nurse Practitioner | 17051 Sierra Lakes Pkwy, Ste 101, Fontana, CA 92336-1274 | 2011-09-01 |
1174760953 | Inland Healthcare Group A Medical Corporation | Internal Medicine | 17051 Sierra Lakes Pkwy, Suite 101, Fontana, CA 92336-1274 | 2009-01-15 |
1750539391 | Tarquin Siam Williams | Physician Assistant | 17051 Sierra Lakes Pkwy, Fontana, CA 92336-1274 | 2008-09-08 |
1629231147 | Christi Lynn Wiley | Family Medicine | 17051 Sierra Lakes Pkwy, Suite 101, Fontana, CA 92336-1274 | 2008-07-03 |
1275717506 | Alfonso Becerra Jr. | Physician Assistant | 17051 Sierra Lakes Pkwy, Fontana, CA 92336-1274 | 2007-12-21 |
1043411374 | Kristine Ryall | Nurse Practitioner | 17051 Sierra Lakes Pkwy, Ste 101, Fontana, CA 92336-1274 | 2007-05-31 |
1265642052 | Jose I Arciniega | Family Medicine | 17051 Sierra Lakes Pkwy, Suite 101, Fontana, CA 92336-1274 | 2007-05-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700361243 | Schmidt and Jefferson Dental Corporation | Dentist | 16944 South Highland Avenue, Ste. 400, Fontana, CA 92336 | 2018-10-01 |
1275032658 | Kenitha Pulliam | Behavioral Analyst | 14051 Catalina Ct, Fontana, CA 92336 | 2018-02-12 |
1568961183 | Jordan Frailey | Marriage & Family Therapist | 9161 Sierra Ave. Suite 213, Fontana, CA 92336 | 2018-02-09 |
1689198905 | Sara Alyssa Lynch | Specialist/Technologist | 7151 Oak Tree Place, Fontana, CA 92336 | 2017-07-28 |
1043749526 | Eric Ceasar Parian Lopez | Registered Nurse | 16001 Pfc Paris Montanez Dr., Fontana, CA 92336 | 2017-06-08 |
1275065393 | Alyssa Calderon | Marriage & Family Therapist | 14335 Quail Ct, Fontana, CA 92336 | 2017-03-29 |
1588029219 | Daisy Maritza Santana | Behavioral Analyst | 16320 Rosa Linda Ln, Fontana, CA 92336 | 2015-12-23 |
1407237498 | Natalie Kathleen Herrera | Physician Assistant | 16456 Sierra Lakes Pkwy, Suite 300, Fontana, CA 92336 | 2015-06-15 |
1255738241 | Southern California Picc Providers, Inc. | Spec/Tech, Cardiovascular | 5787 Little Shay Dr, Fontana, CA 92336 | 2014-11-19 |
1396175758 | Martha C Ajca | Physician Assistant | 17051 Sierra Lakes Parkway, Suite 101, Fontana, CA 92336 | 2013-11-22 |
Find all providers in zip 92336 |
Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780226852 | Dignity Health Medical Foundation | Clinic/Center | 17051 Sierra Lakes Pkwy Ste 101, Fontana, CA 92336-1274 | 2019-10-10 |
1275661084 | Lasalle Medical Associates | Clinic/Center | 17577 Arrow Blvd, Fontana, CA 92335 | 2007-03-01 |
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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.