NPIMap

Organization Active NPI

Integrated Medical Center of Corona Inc.

  • Multi-Specialty Clinic/Center
  • Corona, CA
National Provider Identifier
1023400322
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
39736MD Issued in CA
Legal business name
INTEGRATED MEDICAL CENTER OF CORONA INC.
Practice address
2250 S Main St
Suite 203
Corona, CA 92882-2534
Phone
(951) 737-1252
Fax
(951) 737-2820
NPI assigned
Feb 23, 2015
Last updated
Feb 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Authorized official

Name
Terry Lee Sanderfer, M.D., M.B.A.NPI 1235102401
Title
Persident
Phone
(951) 737-1252

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 39736MD CA Primary

Addresses

Primary practice location

2250 S Main St
Suite 203
Corona, CA 92882-2534

Mailing address

2250 S Main St
Suite 203
Corona, CA 92882-2534
Phone (951) 737-1252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151130000961 CA Part B Supplier - Clinic/Group Practice 4981904737 Receives reassigned benefits from 14 practitioners
Practice locations: Corona, CA; Riverside, CA
O20160902000638 CA DME Supplier - Physician - Unknown Physician Specialty 4981904737 Practice locations: Corona, CA

National Provider Directory

National Provider Directory

Locations

12598 Central Ave
Ste 120
Chino, CA 91710

12598 Central Ave
Ste 120A
Chino, CA 91710
Phone (909) 464-9811

2250 S Main St
Ste 203
Corona, CA 92882
Phone (800) 595-2447

1001 N State St
Hemet, CA 92543
Phone (951) 652-0090

9496 Magnolia Ave
Ste 201
Riverside, CA 92503
Phone (951) 737-1252

370 W 6th St
Ste 100
San Bernardino, CA 92401
Phone (909) 381-3492

32475 Clinton Keith Rd
Ste 108
Wildomar, CA 92595
Phone (909) 609-0399

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1023400322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST",
            "address_2": "SUITE 203",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822534",
            "telephone_number": "951-737-1252",
            "fax_number": "951-737-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST",
            "address_2": "SUITE 203",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822534",
            "telephone_number": "951-737-1252",
            "fax_number": "951-737-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL CENTER OF CORONA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "SANDERFER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PERSIDENT",
        "authorized_official_telephone_number": "951-737-1252",
        "authorized_official_credential": "M.D., M.B.A."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "39736MD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.