Provider Demographics
NPI:1821232182
Name:POMONA HEALTH INC
Entity Type:Organization
Organization Name:POMONA HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLIVER
Authorized Official - Middle Name:OPPERS
Authorized Official - Last Name:AALAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-342-8751
Mailing Address - Street 1:11012 VENTURA BLVD
Mailing Address - Street 2:SUITE 347
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3400
Mailing Address - Country:US
Mailing Address - Phone:909-342-8751
Mailing Address - Fax:909-992-3019
Practice Address - Street 1:1818 N ORANGE GROVE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3028
Practice Address - Country:US
Practice Address - Phone:909-342-8751
Practice Address - Fax:909-992-3019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA716472086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H53910Medicare UPIN
WAG8868781Medicare PIN