FOOTHILLS NEUROLOGICAL MEDICAL GP
NPI 1154317584
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in San Dimas, CA

Q: What is the provider's specialty?

The provider's specialty is Psychiatry & Neurology with taxonomy code 2084N0402X and a focus in Neurology with Special Qualifications in Child Neurology.

Active since September 21, 2005

1330 W COVINA BLVD, #103, SAN DIMAS, CA 91773(909) 592-2145(909) 599-6217 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

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About Foothills Neurological Medical Gp NPPES

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

FOOTHILLS NEUROLOGICAL MEDICAL GP (NPI 1154317584) is a healthcare organization registered as a neurology with special qualifications in child neurology in San Dimas, California and active in the NPI registry since September 2005. The organization lists Gail E Young, Administrator, as its authorized official.

NPPES Registry Identity

NPI1154317584

Entity TypeOrganization

Primary Taxonomy2084N0402X

Legal Business NameFOOTHILLS NEUROLOGICAL MEDICAL GP

Location Address1330 W COVINA BLVD, #103San Dimas, CA 91773-3200

Mailing Address1330 W Covina Blvd, #103San Dimas, CA 91773-3200 · (909) 592-2145 · Fax (909) 599-6217

Phone(909) 592-2145

Fax(909) 599-6217

Organization SubpartNo

Authorized OfficialGail E YoungAdministrator · (909) 592-2145

Enumeration DateSeptember 21, 2005

Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration

✔ NPI 1154317584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0402X

License✔ Licensed in CA · A43523

Definition

A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License A33406 (CA)

1330 W COVINA BLVD, San Dimas, CA 91773

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Other Identifiers 2

Medicaid00A334060CA

Medicaid00A435230CA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP