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SAN DIMAS FAMILY CARE INC.
NPI 1104856947
Family Medicine in San Dimas, CA

Active since July 04, 2006CLIA 05D2056866 · Waiver
150 W. FOOTHILL BLVD., SAN DIMAS, CA 91773(909) 599-9921(909) 592-3147 Get Directions Write a Review

NPPES record last updated: December 11, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About San Dimas Family Care Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAN DIMAS FAMILY CARE INC. (NPI 1104856947) is a healthcare organization registered as a family medicine in San Dimas, California and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through May 21, 2027 and lists Clifford L. Sussman, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1104856947
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSAN DIMAS FAMILY CARE INC.
Location Address150 W. FOOTHILL BLVD.San Dimas, CA 91773-1102
Mailing Address150 W. Foothill BlvdSan Dimas, CA 91773-1102 · (909) 599-9921 · Fax (909) 592-3147
Phone(909) 599-9921
Fax(909) 592-3147
Organization SubpartNo
Authorized OfficialClifford L. SussmanOwner/president · (909) 599-9921
Enumeration DateJuly 4, 2006
Last NPPES UpdateDecember 11, 2008
✔ NPI 1104856947 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
150 W. FOOTHILL BLVD., San Dimas, CA 91773
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Other Identifiers 2

Medicare PINW13176
Medicare ID-Type UnspecifiedW13176CA · Mc Group

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2056866

San Dimas Family Clinic · San Dimas, CA
Active · expires May 21, 2027
CLIA Number05D2056866
Laboratory TypePhysician Office
Certificate Effective DateMay 22, 2025
Certificate Expiration DateMay 21, 2027
Laboratory DirectorClifford L. Sussman, MD
Laboratory Phone(909) 599-9921
Laboratory LocationSan Dimas Family Clinic150 W Foothill Blvd, San Dimas, CA 91773
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is San Dimas Family Care Inc.'s NPI number?

The NPI number for San Dimas Family Care Inc. is 1104856947. It was assigned to this organization in the NPPES registry on July 4, 2006.

Where is San Dimas Family Care Inc. located?

San Dimas Family Care Inc. is located at 150 W. Foothill Blvd., San Dimas, CA 91773. The listed phone number is (909) 599-9921.

What is San Dimas Family Care Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does San Dimas Family Care Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2056866) is associated with this NPI, valid through May 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for San Dimas Family Care Inc. was last updated on December 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.