SAN DIMAS FAMILY CARE
NPI 1952442279
Non-Pharmacy Dispensing Site in San Dimas, CA

Active since February 09, 2007CLIA 05D2056866 · Waiver
150 W FOOTHILL BLVD, SAN DIMAS, CA 91773(909) 599-9921 Get Directions Write a Review

NPPES record last updated: October 17, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About San Dimas Family Care NPPES

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

SAN DIMAS FAMILY CARE (NPI 1952442279) is a healthcare organization registered as a non-pharmacy dispensing site in San Dimas, California and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through May 21, 2027 and lists Kenny Heine, Dir. Of Operations, as its authorized official.

NPPES Registry Identity

NPI1952442279
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameSAN DIMAS FAMILY CARE, A MEDICAL CORPORATION
Location Address150 W FOOTHILL BLVDSan Dimas, CA 91773-1102
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705 · (858) 625-2990 · Fax (858) 625-2999
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineDir. Of Operations · (858) 625-2990
Enumeration DateFebruary 9, 2007
Last NPPES UpdateOctober 17, 2012
NPI 1952442279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License Licensed in CA · A45906
Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

150 W FOOTHILL BLVD, San Dimas, CA 91773

Other Names 1

Doing Business AsSan Dimas Family Care

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 05D2056866

San Dimas Family Clinic · San Dimas, CA
Active · expires May 21, 2027
CLIA Number05D2056866
Laboratory TypePhysician Office
Certificate Effective DateMay 22, 2025
Certificate Expiration DateMay 21, 2027
Laboratory DirectorClifford L. Sussman, MD
Laboratory Phone(909) 599-9921
Laboratory LocationSan Dimas Family Clinic150 W Foothill Blvd, San Dimas, CA 91773
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 12

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

Family Medicine
150 W FOOTHILL BLVD
SAN DIMAS, CA 91773
Physician Assistant (Medical)
150 W FOOTHILL BLVD
SAN DIMAS, CA 91773
Family Medicine
150 W FOOTHILL BLVD
SAN DIMAS, CA 91773
Internal Medicine
150 W FOOTHILL BLVD
SAN DIMAS, CA 91773
Dentist (Pediatric Dentistry)
150 W FOOTHILL BLVD, SUITE E
SAN DIMAS, CA 91773
Non-Pharmacy Dispensing Site
150 W FOOTHILL BLVD
SAN DIMAS, CA 91773
Behavior Technician
150 W FOOTHILL BLVD
SAN DIMAS, CA 91773
Nurse Practitioner (Family)
150 W FOOTHILL BLVD
SAN DIMAS, CA 91773

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 San Dimas Family Care, A Medical Corporation's NPI number?

The NPI number for San Dimas Family Care, A Medical Corporation is 1952442279. It was assigned to this organization in the NPPES registry on February 9, 2007. The provider is doing business as San Dimas Family Care.

Where is San Dimas Family Care, A Medical Corporation located?

San Dimas Family Care, A Medical Corporation is located at 150 W Foothill Blvd, San Dimas, CA 91773. The listed phone number is (909) 599-9921.

What is San Dimas Family Care, A Medical Corporation's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does San Dimas Family Care, A Medical Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2056866) is associated with this NPI, valid through May 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for San Dimas Family Care, A Medical Corporation was last updated on October 17, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.