Individual provider Active NPI

Miriam Cho, M.D

  • Geriatric Medicine (Family Medicine) Physician
  • Riverside, CA
National Provider Identifier
1003036187
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
A99950 Issued in CA
Practice address
7117 Brockton Ave
Riverside, CA 92506-2658
Phone
(951) 782-3616
Fax
(951) 784-3268
NPI assigned
Apr 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X A99950 CA Primary

Addresses

Primary practice location

7117 Brockton Ave
Riverside, CA 92506-2658

Mailing address

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 782-3616

Other identifiers 2

IdentifierTypeStateIssuer
A99950OtherCALICENSE
ZZZ31887ZOtherCASITE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081106000771 CA Practitioner - Geriatric MedicinePractitioner - Family Practice 4688733587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
Loma Linda University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical Group 11,250 clinicians
Riverside Medical Clinic Inc 173 clinicians

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 683-6370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A99950CAMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Apr 29, 2024 Accepting new patients
Riverside Medical Clinic, Inc CurrentSince Aug 24, 2009 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 29, 2024 Accepting new patients
Riverside Medical Clinic, Inc Current Accepting new patients
Riverside Medical Clinic, Inc CurrentSince Aug 24, 2009 Accepting new patients

Locations

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1003036187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-3616",
            "fax_number": "951-784-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-3616",
            "fax_number": "951-784-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHO",
        "first_name": "MIRIAM",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-30",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A99950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A99950",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE PTAN",
            "identifier": "ZZZ31887Z",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.