Healthcare Provider Details

I. General information

NPI: 1417211426
Provider Name (Legal Business Name): POMONA COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2012
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 E HOLT AVE
POMONA CA
91767-5822
US

IV. Provider business mailing address

1450 E HOLT AVE
POMONA CA
91767-5822
US

V. Phone/Fax

Practice location:
  • Phone: 909-630-7927
  • Fax: 909-620-6719
Mailing address:
  • Phone: 909-630-7927
  • Fax: 909-469-0065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateCA

VIII. Authorized Official

Name: DAVID MICHAEL KADAR
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 909-630-7939