| Vituity Physician Services PC | |
|
16888 Baseline Ave Fontana CA 92336-2083 | |
| (855) 422-8029 | |
| Not Available |
| Full Name | Vituity Physician Services PC |
|---|---|
| Speciality | Family Medicine |
| Location | 16888 Baseline Ave, Fontana, California |
| Authorized Official Name and Position | David Andrew Birdsall (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 5103502600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vituity Physician Services PC 2100 Powell St Ste 400 Emeryville CA 94608-1872 | Vituity Physician Services PC 16888 Baseline Ave Fontana CA 92336-2083 Ph: (855) 422-8029 |
| NPI Number | 1124884176 |
|---|---|
| Provider Enumeration Date | 02/27/2024 |
| Last Update Date | 07/31/2024 |
| Certification Date | 07/31/2024 |
| Medicare PECOS PAC ID | 0749620888 |
|---|---|
| Medicare Enrollment ID | O20240506004038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124884176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Ruben R Avagimov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558376947 PECOS PAC ID: 4385540574 Enrollment ID: I20031209000592 |
| Provider Name | Pooja Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497762355 PECOS PAC ID: 7416927710 Enrollment ID: I20040726001110 |
| Provider Name | James Timothy Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104858059 PECOS PAC ID: 7416916507 Enrollment ID: I20041005000705 |
| Provider Name | Luis M Chaname |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992712830 PECOS PAC ID: 1355398157 Enrollment ID: I20050404001075 |
| Provider Name | Sabry F Ghaly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588706105 PECOS PAC ID: 0840231585 Enrollment ID: I20050512000761 |
| Provider Name | Edward a Pillar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295750941 PECOS PAC ID: 9739081852 Enrollment ID: I20050630001149 |
| Provider Name | Muhammad Arif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396728564 PECOS PAC ID: 3476589151 Enrollment ID: I20050713001141 |
| Provider Name | Rubin Lin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679678916 PECOS PAC ID: 5597840025 Enrollment ID: I20080307000635 |
| Provider Name | Deborah E Small |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437166295 PECOS PAC ID: 6608951033 Enrollment ID: I20080310000634 |
| Provider Name | Carol H Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043251143 PECOS PAC ID: 1254418072 Enrollment ID: I20080403000400 |
| Provider Name | Rodney W Borger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619917465 PECOS PAC ID: 2961581244 Enrollment ID: I20080512000588 |
| Provider Name | Inga P Jeon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346435476 PECOS PAC ID: 2466522925 Enrollment ID: I20080610000489 |
| Provider Name | Aimee M Vercio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720298672 PECOS PAC ID: 4880760263 Enrollment ID: I20080909000353 |
| Provider Name | Rosa M Cortes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154338010 PECOS PAC ID: 4082774310 Enrollment ID: I20081117000647 |
| Provider Name | Edward M Keiderling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457366841 PECOS PAC ID: 6507926839 Enrollment ID: I20081117000673 |
| Provider Name | Debra D Craig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255351151 PECOS PAC ID: 4789745266 Enrollment ID: I20081202000532 |
| Provider Name | Nancy C Moore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538361464 PECOS PAC ID: 2961595327 Enrollment ID: I20101006000946 |
| Provider Name | Joachim M Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366677197 PECOS PAC ID: 4385839315 Enrollment ID: I20101116000443 |
| Provider Name | Marianna E Ronay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508089897 PECOS PAC ID: 2062692767 Enrollment ID: I20110214000180 |
| Provider Name | Juan Velasquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770585192 PECOS PAC ID: 7719167428 Enrollment ID: I20110214000383 |
| Provider Name | Nguyen-phuong D Pham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558516823 PECOS PAC ID: 3779764105 Enrollment ID: I20110218000143 |
| Provider Name | Siraj M Mowjood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588988588 PECOS PAC ID: 0042481368 Enrollment ID: I20110919000167 |
| Provider Name | Michael a Tomkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386914778 PECOS PAC ID: 6709049307 Enrollment ID: I20120517000649 |
| Provider Name | Paul E Lyons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588652515 PECOS PAC ID: 4082519228 Enrollment ID: I20120816000178 |
| Provider Name | Claudia S Padilla |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255696209 PECOS PAC ID: 8729228432 Enrollment ID: I20130701000136 |
| Provider Name | Heather H Bohn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043504004 PECOS PAC ID: 1759517493 Enrollment ID: I20131202000866 |
| Provider Name | Zeenath Masood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881963130 PECOS PAC ID: 2365660370 Enrollment ID: I20140903001983 |
| Provider Name | Ower C Castro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588950216 PECOS PAC ID: 2062641970 Enrollment ID: I20141013001087 |
| Provider Name | Christina T Tadrous |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780922468 PECOS PAC ID: 9234351628 Enrollment ID: I20141120000211 |
| Provider Name | Eugene Ho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407129273 PECOS PAC ID: 4284956590 Enrollment ID: I20141121002163 |
| Provider Name | Emily J Robison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417227141 PECOS PAC ID: 3870816812 Enrollment ID: I20141227000034 |
| Provider Name | Anushree Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043574403 PECOS PAC ID: 5092022814 Enrollment ID: I20150910002985 |
| Provider Name | Maria G Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780947499 PECOS PAC ID: 5890005433 Enrollment ID: I20151110002182 |
| Provider Name | Tracy a Preston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255630398 PECOS PAC ID: 4789987785 Enrollment ID: I20160126000835 |
| Provider Name | Reza Talebi Dolouei |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639431836 PECOS PAC ID: 6507167053 Enrollment ID: I20160908001938 |
| Provider Name | David Ahamba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669885885 PECOS PAC ID: 3678863941 Enrollment ID: I20170807002761 |
| Provider Name | Sepehr Golboo |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1164836896 PECOS PAC ID: 7719259084 Enrollment ID: I20170821003378 |
| Provider Name | Frances Mcintyre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871932723 PECOS PAC ID: 7517239817 Enrollment ID: I20170822001433 |
| Provider Name | Jennifer L Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255745980 PECOS PAC ID: 5991071839 Enrollment ID: I20171020002938 |
| Provider Name | Kenneth D Herrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629576244 PECOS PAC ID: 3971864125 Enrollment ID: I20180302001425 |
| Provider Name | Jennifer Luong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548640899 PECOS PAC ID: 5991084253 Enrollment ID: I20180629001844 |
| Provider Name | Leala B Lettice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386023604 PECOS PAC ID: 8527319136 Enrollment ID: I20180920002433 |
| Provider Name | Xavier Bermudez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124414651 PECOS PAC ID: 8325311723 Enrollment ID: I20190212003154 |
| Provider Name | Peter Bastian |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1710299821 PECOS PAC ID: 7315288818 Enrollment ID: I20190410001855 |
| Provider Name | Ali J Zamora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861034282 PECOS PAC ID: 4385071414 Enrollment ID: I20200302000125 |
| Provider Name | Jonathan Jinesta |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811535222 PECOS PAC ID: 4082042411 Enrollment ID: I20200319000456 |
| Provider Name | Nancy Chung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275053688 PECOS PAC ID: 2365867389 Enrollment ID: I20200729000530 |
| Provider Name | Nehemiah S Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821519182 PECOS PAC ID: 7810313780 Enrollment ID: I20200819002165 |
| Provider Name | Narges Moaddel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770004012 PECOS PAC ID: 1153733571 Enrollment ID: I20201209000591 |
| Provider Name | Ashley N Molina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780181289 PECOS PAC ID: 0648674713 Enrollment ID: I20210811002599 |
| Provider Name | Diem-trinh T Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780159806 PECOS PAC ID: 3072911197 Enrollment ID: I20211004002810 |
| Provider Name | Nehal N Gandhi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679070098 PECOS PAC ID: 2668861782 Enrollment ID: I20211111000889 |
| Provider Name | Arnel Cadiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861168551 PECOS PAC ID: 1052702842 Enrollment ID: I20220105002325 |
| Provider Name | Dorian Valdez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003588914 PECOS PAC ID: 0547647794 Enrollment ID: I20220510001050 |
| Provider Name | Rachel Shira Kaufman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669038154 PECOS PAC ID: 5092199406 Enrollment ID: I20220902002864 |
| Provider Name | Ulisses Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669033908 PECOS PAC ID: 8224412424 Enrollment ID: I20220907003917 |
| Provider Name | Magen Ashley Costilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023756194 PECOS PAC ID: 6103295613 Enrollment ID: I20221205002885 |
| Provider Name | Shamjana Acharya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811616642 PECOS PAC ID: 8729450309 Enrollment ID: I20230207003616 |
| Provider Name | Kristian D'ann Miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578815106 PECOS PAC ID: 4587038591 Enrollment ID: I20230314002503 |
| Provider Name | Manuel Alejandro Cruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699302455 PECOS PAC ID: 3779991708 Enrollment ID: I20230526002082 |
| Provider Name | Barbara Milbert Namayanja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386330470 PECOS PAC ID: 8527426642 Enrollment ID: I20230622001604 |
| Provider Name | Jonathan K Goorhuis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548898810 PECOS PAC ID: 3173986072 Enrollment ID: I20230824003514 |
| Provider Name | Christina S Sugirtharaj |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073135570 PECOS PAC ID: 2163877440 Enrollment ID: I20231005002015 |
| Provider Name | Djordje Milivojevic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225612674 PECOS PAC ID: 2668879321 Enrollment ID: I20240103003066 |
| Provider Name | Kristy Matschullat |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063702116 PECOS PAC ID: 8022294255 Enrollment ID: I20240509003851 |
| Provider Name | Bradley Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447993530 PECOS PAC ID: 5890237176 Enrollment ID: I20240603002614 |
| Provider Name | Shantela Stanfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083233894 PECOS PAC ID: 7214389238 Enrollment ID: I20240611004456 |
| Provider Name | Irina Lucian Turlea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407535933 PECOS PAC ID: 3476096538 Enrollment ID: I20240617003338 |
| Provider Name | Carlos Alberto Banuelos Ramirez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346008414 PECOS PAC ID: 9830634195 Enrollment ID: I20240710004136 |
| Provider Name | Renee a Higa-tanner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942943170 PECOS PAC ID: 3375919772 Enrollment ID: I20241015004779 |
| Provider Name | Shawn Elliott Kratofil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780448803 PECOS PAC ID: 2163950411 Enrollment ID: I20250114002234 |
| Provider Name | Jessica C Grier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881254878 PECOS PAC ID: 8123558590 Enrollment ID: I20250214000226 |
| Provider Name | Eliza Kym Liwanag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245935915 PECOS PAC ID: 8820519168 Enrollment ID: I20250304000646 |
| Provider Name | Enkhsaikhan Munkhbold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972184810 PECOS PAC ID: 8921529298 Enrollment ID: I20250304001582 |
| Provider Name | Jesse Duro |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417720376 PECOS PAC ID: 7911429022 Enrollment ID: I20250318003341 |
| Provider Name | Raghad Al-aubid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184363012 PECOS PAC ID: 7810373818 Enrollment ID: I20250728002332 |
| Provider Name | Tara Riguis Weaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447993357 PECOS PAC ID: 6507364288 Enrollment ID: I20250812002033 |
| Provider Name | Katherine Huay-hsien Goh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023751450 PECOS PAC ID: 5799285276 Enrollment ID: I20250820004202 |
| Provider Name | Sameet Moor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366964678 PECOS PAC ID: 6204100290 Enrollment ID: I20251013001416 |
| Provider Name | Lily Chorbadjian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336889781 PECOS PAC ID: 1153818182 Enrollment ID: I20251014002753 |
| Provider Name | Allan Gene Padua Alcasid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821739723 PECOS PAC ID: 3577050475 Enrollment ID: I20251014003499 |
| Provider Name | Maerah Ahmed |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164233789 PECOS PAC ID: 2668961269 Enrollment ID: I20251031003658 |
| Provider Name | Nichole Sayegh |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811542368 PECOS PAC ID: 3971093246 Enrollment ID: I20251105002419 |
| Provider Name | Litzy Deborah Medel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841184538 PECOS PAC ID: 7315437647 Enrollment ID: I20251105003594 |
| Provider Name | Samantha Quynh-vi Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134960321 PECOS PAC ID: 8628561172 Enrollment ID: I20251203001123 |
| Provider Name | Udhaya Aelety |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740815943 PECOS PAC ID: 4385045178 Enrollment ID: I20260313002213 |
| Provider Name | Takeysha Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497508303 PECOS PAC ID: 5597237834 Enrollment ID: I20260617002614 |
Unicare Community Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 17500 Foothill Blvd Ste A2, Fontana, CA 92335 Phone: 909-428-0170 |
Senior's Choice Medical Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8990 Sierra Avenue, Suite J&k, Fontana, CA 92335 Phone: 909-421-4886 |
VK Medical Group Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16359 Brook Ln, Fontana, CA 92336 Phone: 408-571-9333 |
Pinnacle Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16655 Foothill Blvd, Fontana, CA 92335 Phone: 909-427-1303 Fax: 909-796-4158 |
Alav Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16465 Sierra Lakes Pkwy, Ste 220, Fontana, CA 92336 Phone: 909-434-1123 Fax: 909-261-8082 |
Internal Medicine Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16465 Sierra Lakes Parkway, Internal Medicine Medical Group Suite, Fontana, CA 92336 Phone: 909-770-8640 Fax: 909-770-8650 |