CARBON HEALTH MEDICAL GROUP OF CALIFORNIA PC
NPI 1033991773
Non-Pharmacy Dispensing Site in Chino Hills, CA

NPI Status: Active since October 17, 2023

Contact Information

15840 SOQUEL CANYON PKWY STE E&G
CHINO HILLS, CA
ZIP 91709
Phone: (909) 479-2764

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  • Organization
  • Non-Pharmacy Dispensing Site
  • CLIA Number: 05D2288708
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-28-2025

About CARBON HEALTH MEDICAL GROUP OF CALIFORNIA PC

This page provides the complete NPI Profile along with additional information for Carbon Health Medical Group Of California Pc, a provider established in Chino Hills, California operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1033991773 assigned on October 2023. The practitioner's primary taxonomy code is 332900000X. The provider is registered as an organization and their NPI record was last updated June 2025. The authorized official of this NPI record is Marley Page (Director)

NPI
1033991773
Provider Name
CARBON HEALTH MEDICAL GROUP OF CALIFORNIA PC
Entity Type
Organization
Location Address
15840 SOQUEL CANYON PKWY STE E&G CHINO HILLS, CA 91709
Location Phone
(909) 479-2764
Mailing Address
2100 FRANKLIN ST STE 355 OAKLAND, CA 94612
Mailing Phone
(415) 446-1733
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-17-2023
Last Update Date
06-24-2025
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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

Non-Pharmacy Dispensing Site

Taxonomy Code
332900000X
Type
Suppliers
Taxonomy Description
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.)

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

MARLEY PAGE

Authorized Official Title
DIRECTOR
Authorized Official Phone
(417) 861-9739

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2288708
Facility Type
Physician Office
Certificate Effective Date
August 29, 2023
Certificate Expiration Date
August 28, 2025
Laboratory Director
SUJAL MANDAVIA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Carbon Health Medical Group Of California Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1033991773
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20631892714
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 6 + 3 + 1 + 8 + 9 + 2 + 7 + 1 + 4 + 24 = 67
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 67 = 33

The NPI number 1033991773 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033991773, enumerated in the NPI registry as an "organization" on October 17, 2023

The provider is located at 15840 Soquel Canyon Pkwy Ste E&g Chino Hills, Ca 91709 and the phone number is (909) 479-2764

This medical organization specializes in Non-Pharmacy Dispensing Site with taxonomy code 332900000X

The provider's CLIA number is 05D2288708 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on October 17, 2023. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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