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POMONA PEDIATRICS
NPI 1366447781
Pediatrics in Pomona, CA

Active since June 14, 2005CLIA 05D0677550 · Waiver
250 W BONITA AVE, #200, POMONA, CA 91767(909) 620-1935(909) 865-7688 Get Directions Write a Review

NPPES record last updated: July 30, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pomona Pediatrics NPPES

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

POMONA PEDIATRICS (NPI 1366447781) is a healthcare organization registered as a pediatrics in Pomona, California and active in the NPI registry since June 2005. The organization holds a CLIA Waiver certificate valid through March 2, 2028 and lists Jim Hollenberg, Staff/it, as its authorized official.

NPPES Registry Identity

NPI1366447781
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameHOLLENBERG AGRAWAL KNOLL WARREN HONG FUNG TILLIS KAUSHAL MDS
Location Address250 W BONITA AVE, #200Pomona, CA 91767-1850
Mailing Address250 W Bonita Ave, #200Pomona, CA 91767-1850 · (909) 620-1935 · Fax (909) 865-7688
Phone(909) 620-1935
Fax(909) 865-7688
Organization SubpartNo
Authorized OfficialJim HollenbergStaff/it · (909) 620-1935
Enumeration DateJune 14, 2005
Last NPPES UpdateJuly 30, 2014
✔ NPI 1366447781 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
250 W BONITA AVE, Pomona, CA 91767
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Other Names 1

Doing Business AsPomona Pediatrics

Other Identifiers 1

OtherGR0066720CA · Medi Cal Group Number

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 05D0677550

Hollenberg, Agrawal, Knoll, Warren, Hong, & Tillis · Pomona, CA
Active · expires Mar 2, 2028
CLIA Number05D0677550
Laboratory TypePhysician Office
Certificate Effective DateMarch 3, 2026
Certificate Expiration DateMarch 2, 2028
Laboratory DirectorJames T. Warren MD
Laboratory Phone(909) 620-1935
Laboratory LocationHollenberg, Agrawal, Knoll, Warren, Hong, & Tillis250 W Bonita Ave Ste 200, Pomona, CA 91767
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JAMES T. WARREN M.D.
Pediatrics
250 W BONITA AVE, #200
POMONA, CA 91767
Los Angeles County (909) 629-5067
BRYAN X LEE MD A PROFESSIONAL MEDICAL CORPORATION
Pain Medicine (Interventional Pain Medicine)
250 W BONITA AVE, SUITE 160
POMONA, CA 91767
Los Angeles County (909) 593-1002
DR. CARRIE E. KNOLL M.D.
Pediatrics
250 W BONITA AVE, #200
POMONA, CA 91767
Los Angeles County (909) 629-5067
JASON H. SHIN, MD, INC., A PROFESSIONAL MEDICAL CORPORATION
Clinic/Center
250 W BONITA AVE, SUITE 250
POMONA, CA 91767
Los Angeles County (909) 593-2031
DR. JASON HAESHIK SHIN M. D.
Internal Medicine (Gastroenterology)
250 W BONITA AVE, SUITE 250
POMONA, CA 91767
Los Angeles County (909) 593-2031
DR. SANDRA A. HOLLENBERG M.D.
Pediatrics
250 W BONITA AVE, #200
POMONA, CA 91767
Los Angeles County (909) 629-5067
DR. BRYAN XIAO-QIU LEE MD
Pain Medicine (Interventional Pain Medicine)
250 W BONITA AVE, SUITE 160
POMONA, CA 91767
Los Angeles County (909) 593-1002
JAGTAR DHADWAL, MD. INC.
Internal Medicine
250 W BONITA AVE, SUITE 250
POMONA, CA 91767
Los Angeles County (909) 868-6800

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 Hollenberg Agrawal Knoll Warren Hong Fung Tillis Kaushal Mds's NPI number?

The NPI number for Hollenberg Agrawal Knoll Warren Hong Fung Tillis Kaushal Mds is 1366447781. It was assigned to this organization in the NPPES registry on June 14, 2005. The provider is doing business as Pomona Pediatrics.

Where is Hollenberg Agrawal Knoll Warren Hong Fung Tillis Kaushal Mds located?

Hollenberg Agrawal Knoll Warren Hong Fung Tillis Kaushal Mds is located at 250 W Bonita Ave #200, Pomona, CA 91767. The listed phone number is (909) 620-1935.

What is Hollenberg Agrawal Knoll Warren Hong Fung Tillis Kaushal Mds's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Hollenberg Agrawal Knoll Warren Hong Fung Tillis Kaushal Mds hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0677550) is associated with this NPI, valid through March 2, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Hollenberg Agrawal Knoll Warren Hong Fung Tillis Kaushal Mds was last updated on July 30, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.