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ULTIMATE MEDICAL PRACTICE A PROFESSIONAL CORPORATION
NPI 1962659573
Clinic/Center - Primary Care in Highland, CA

Active since August 26, 2008CLIA 05D1086304 · Waiver
3654 HIGHLAND AVE, SUITE 15, HIGHLAND, CA 92346(909) 864-1006(909) 864-1625 Get Directions Write a Review

NPPES record last updated: March 4, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ultimate Medical Practice A Professional Corporation NPPES

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

ULTIMATE MEDICAL PRACTICE A PROFESSIONAL CORPORATION (NPI 1962659573) is a healthcare organization registered as a primary care in Highland, California and active in the NPI registry since August 2008. The organization holds a CLIA Waiver certificate valid through December 17, 2026 and lists Richard Kangah, Medical Director/president, as its authorized official.

NPPES Registry Identity

NPI1962659573
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameULTIMATE MEDICAL PRACTICE A PROFESSIONAL CORPORATION
Location Address3654 HIGHLAND AVE, SUITE 15Highland, CA 92346-2614
Mailing Address3654 Highland Ave, Suite 15Highland, CA 92346-2614 · (909) 864-1006 · Fax (909) 864-1625
Phone(909) 864-1006
Fax(909) 864-1625
Organization SubpartNo
Authorized OfficialRichard KangahMedical Director/president · (909) 864-1006
Enumeration DateAugust 26, 2008
Last NPPES UpdateMarch 4, 2009
✔ NPI 1962659573 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in CA · A55122
3654 HIGHLAND AVE, Highland, CA 92346
Open in Google Maps ↗

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 05D1086304

Ultimate Medical Practice Inc · Highland, CA
Active · expires Dec 17, 2026
CLIA Number05D1086304
Laboratory TypeCommunity Clinic
Certificate Effective DateDecember 18, 2024
Certificate Expiration DateDecember 17, 2026
Laboratory DirectorRichard Kangah MD
Laboratory Phone(909) 864-1006
Laboratory LocationUltimate Medical Practice Inc3606 E Highland Ave Ste 108, Highland, CA 92346
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Ultimate Medical Practice A Professional Corporation's NPI number?

The NPI number for Ultimate Medical Practice A Professional Corporation is 1962659573. It was assigned to this organization in the NPPES registry on August 26, 2008.

Where is Ultimate Medical Practice A Professional Corporation located?

Ultimate Medical Practice A Professional Corporation is located at 3654 Highland Ave Suite 15, Highland, CA 92346. The listed phone number is (909) 864-1006.

What is Ultimate Medical Practice A Professional Corporation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Ultimate Medical Practice A Professional Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1086304) is associated with this NPI, valid through December 17, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ultimate Medical Practice A Professional Corporation was last updated on March 4, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.