=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427917889
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | POMONA COMMUNITY HEALTH CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2026
-----------------------------------------------------
Last Update Date | 01/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1450 E HOLT AVE
-----------------------------------------------------
City | POMONA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91767-5822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-630-7927
-----------------------------------------------------
Fax | 909-469-0065
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1450 E HOLT AVE
-----------------------------------------------------
City | POMONA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91767-5822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-630-7939
-----------------------------------------------------
Fax | 909-469-0065
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | DAVID MICHAEL KADAR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 909-630-7939
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171M00000X
-----------------------------------------------------
Taxonomy Name | Case Manager/Care Coordinator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------