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MONTCLAIR VIDA HEALTH CLINIC PC
NPI 1699034827
Clinic/Center - Health Service in Montclair, CA

Active since May 08, 2012
5404 MORENO ST, SUITE N&P, MONTCLAIR, CA 91763(909) 949-4400(909) 949-4441 Get Directions Write a Review

NPPES record last updated: June 7, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Other Providers Same Location
  5. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Health Service

About MONTCLAIR VIDA HEALTH CLINIC PC

This page provides the complete NPI Profile along with additional information for Montclair Vida Health Clinic Pc, a provider established in Montclair, California operating as a Clinic/center, focusing in health service . The healthcare provider is registered in the NPI registry with number 1699034827 assigned on May 2012. The practitioner's primary taxonomy code is 261QH0100X with license number 20A8311 (CA). The provider is registered as an organization and their NPI record was last updated 8 years ago. The authorized official of this NPI record is Ginger L Leon D.o. (Medical Director)

NPI
1699034827 Verify this NPI
Provider Name
MONTCLAIR VIDA HEALTH CLINIC PC
Entity Type
Organization
Location Address
5404 MORENO ST SUITE N&P MONTCLAIR, CA 91763
Location Phone
(909) 949-4400
Location Fax
(909) 949-4441
Mailing Address
5404 MORENO ST SUITE N&P MONTCLAIR, CA 91763
Mailing Phone
(909) 949-4400
Mailing Fax
(909) 949-4441
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-08-2012
Last Update Date
06-07-2018
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Location Map

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 Health Service

Taxonomy Code
261QH0100X
Type
Ambulatory Health Care Facilities
License No.
20A8311
License State
CA

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

GINGER L LEON D.O.

Authorized Official Title
MEDICAL DIRECTOR
Authorized Official Phone
(909) 949-4400

Reviews for MONTCLAIR VIDA HEALTH CLINIC PC

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Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

DR. GINGER LINA LEON D.O.
Family Medicine
5404 MORENO ST, STE. N
MONTCLAIR, CA 91763
San Bernardino County (909) 949-4400
MARTIN MADRIGAL PA-C
Physician Assistant (Medical)
5404 MORENO ST, SUITE N
MONTCLAIR, CA 91763
San Bernardino County (909) 949-4400
LEON FOREFRONT MEDICAL SERVICES INC.
Family Medicine
5404 MORENO ST
MONTCLAIR, CA 91763
San Bernardino County (714) 335-7495

Frequently Asked Questions

What is MONTCLAIR VIDA HEALTH CLINIC PC's NPI number?

The NPI number assigned to this healthcare provider is 1699034827, enumerated as an "organization" on May 08, 2012.

Where is the provider located?

The provider is located at 5404 MORENO ST SUITE N&P MONTCLAIR, CA 91763 and the phone number is (909) 949-4400.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QH0100X and a focus in Health Service.