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WISE FARGO M.D.
NPI 1619990322
Pediatrics in Loma Linda, CA

Active since July 25, 2006
11370 ANDERSON ST, STE B-100, LOMA LINDA, CA 92354(909) 558-2848 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wise Fargo M.d. NPPES

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

WISE FARGO M.D. (NPI 1619990322) is an individual pediatrics provider in Loma Linda, California, licensed in California (A39502) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1619990322
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameWISE FARGOCredential: M.D.
Location Address11370 ANDERSON ST, STE B-100Loma Linda, CA 92354-3450
Mailing Address54701 File NumberLos Angeles, CA 90074-4701 · (909) 558-3111
Phone(909) 558-2848
Sole ProprietorNo
Enumeration DateJuly 25, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1619990322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A39502
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.
11370 ANDERSON ST, Loma Linda, CA 92354
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Other Identifiers 3

Medicaid00A395020CA
Medicare ID-Type Unspecified00A395020
Medicare UPINE72039

Other Providers at the Same Location NPPES 20

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

JOHN Y KIM M.D.
Otolaryngology
11370 ANDERSON ST, SUITE 2100
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2822
EDMUND YUEY KUN KO M.D.
Urology
11370 ANDERSON ST, SUITE 1100
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2830
SNORRI OLAFSSON M.D.
Internal Medicine (Gastroenterology)
11370 ANDERSON ST, STE 3150
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2191
SIGVE K. TONSTAD M.D.
Internal Medicine
11370 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2870
KHASHAYAR DASHTIPOUR M.D.
Psychiatry & Neurology (Neurology)
11370 ANDERSON ST, SUITE 2400
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2880
DOUGLAS DEMING M.D.
Pediatrics (Neonatal-Perinatal Medicine)
11370 ANDERSON ST, STE B-100
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2848
ABEL TORRES M.D.
Dermatology (MOHS-Micrographic Surgery)
11370 ANDERSON ST, STE 2600
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2055
MIA NEPOMUCENO-PEREZ M.D.
Pathology (Anatomic Pathology)
11370 ANDERSON ST, STE 2960
LOMA LINDA, CA 92354
San Bernardino County (909) 558-6422

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 Wise Fargo's NPI number?

The NPI number for Wise Fargo is 1619990322. It was assigned to this individual provider in the NPPES registry on July 25, 2006.

Where is Wise Fargo located?

Wise Fargo practices at 11370 Anderson St Ste B-100, Loma Linda, CA 92354. The listed phone number is (909) 558-2848.

What is Wise Fargo's specialty?

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

When was this NPI record last updated?

The NPPES record for Wise Fargo was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.