Southern California Permanente Medical Group
Organization Active NPI Health Maintenance Organization · Hemet, CA
NPI 1013433465 · NPPES record last updated May 27, 2021
Key facts
- NPI
- 1013433465
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Maintenance Organization 302R00000X
- Legal business name
- SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
- Practice address
- 3527 W Florida Ave
Hemet, CA 92545-3564 - Phone
- (877) 608-0044
- NPI assigned
- Aug 17, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Ramin Davidoff
- Title
- Executive Medical Director
- Phone
- (877) 608-0044
Other NPIs on the same Medicare enrollment 7
Practitioners 753
-
Afshan Roohi Abbasi, M.D.
-
Sridevi Abboy, MD
-
Jordan A Adams, PT
-
Shivali Agarwal, M.D.
-
Endre Agoston, MD
-
Michael John Aguinaldo, M.D.
-
Syed Ajaz Ahmed, MD
-
John Ahn, MD
-
Nadia Akhlaq, M.D
-
Mustansar Akhtar, MD
-
Claudia Alas, M.D.
-
Muhammad Ali, M.D.
-
Michael Anthony Amadeo, N.P.
-
Art Anthony Ambrosio, MD, MBA
-
Linnea Shen Amesur, D.O.
-
Sameer Amin, MD
-
Eric Cruz Arambulo, M.D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040126000823 | CA | Part B Supplier - Clinic/Group Practice | 6002729175 |
Receives reassigned benefits from 5,496 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | Yes |
Addresses
Primary practice location
3527 W Florida Ave
Hemet, CA 92545-3564
Mailing address
393 E Walnut St FL 3
Pasadena, CA 91188-0011
Other names
- Target Clinic Medical Associates
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondingg | Health Information Exchange (HIE) |
Other providers in Hemet, CA
- Eugenie Souisa
- Soul in Mind Psychological Services Inc
- Soul in Mind Psychological Services, SBC
- Christine Sousa
- Southern California Emergency Medicine
- Southern Coast Psych Medical Associates PC
- Southland Arthrites and Osteoporosis Medical Center Inc
- Southland Endoscopy Center
- Southland Hematology Oncology Medical Group, Inc
- Special Care Transportation Inc
All providers in Hemet, CA · Health Maintenance Organization in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.