PARK SIERRA MEDICAL CLINIC INC
NPI 1184833428
Clinic/Center in Colton, CA

NPI Status: Active since May 22, 2007

Contact Information

1023 S MOUNT VERNON AVE STE A
COLTON, CA
ZIP 92324
Phone: (909) 533-4443
Fax: (909) 533-4483

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  • Organization
  • Clinic/Center
  • CLIA Number: 05D1077520
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 01-12-2028

About PARK SIERRA MEDICAL CLINIC INC

This page provides the complete NPI Profile along with additional information for Park Sierra Medical Clinic Inc, a provider established in Colton, California operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1184833428 assigned on May 2007. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Anil Donald Mall Md (Owner)

NPI
1184833428
Provider Name
PARK SIERRA MEDICAL CLINIC INC
Entity Type
Organization
Location Address
1023 S MOUNT VERNON AVE STE A COLTON, CA 92324
Location Phone
(909) 533-4443
Location Fax
(909) 533-4483
Mailing Address
1023 S MOUNT VERNON AVE STE A COLTON, CA 92324
Mailing Phone
(909) 533-4443
Mailing Fax
(909) 533-4483
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-22-2007
Last Update Date
09-09-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center

Taxonomy Code
261Q00000X
Type
Ambulatory Health Care Facilities
Taxonomy Description
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ANIL DONALD MALL MD

Authorized Official Title
OWNER
Authorized Official Phone
(909) 533-4443

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D1077520
Facility Type
Physician Office
Certificate Effective Date
January 13, 2026
Certificate Expiration Date
January 12, 2028
Laboratory Director
ANIL D. MALL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Park Sierra Medical Clinic Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1184833428, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
4
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
3
Unchanged
Pos 7
3
Doubled → 6
Pos 8
4
Unchanged
Pos 9
2
Doubled → 4
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 8 → 16 → 7 3 → 6 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 6 + 4 + 1 + 6 + 3 + 6 + 4 + 4 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1184833428.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Family Medicine
1023 S MOUNT VERNON AVE STE A
COLTON, CA 92324

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1184833428, enumerated as an "organization" on May 22, 2007.

The provider is located at 1023 S MOUNT VERNON AVE STE A COLTON, CA 92324 and the phone number is (909) 533-4443.

Clinic/Center with taxonomy code 261Q00000X.