Organization Active NPI

Sugihara Surgical Services Inc

  • Surgery Physician
  • Upland, CA
National Provider Identifier
1063938553
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A142557 Issued in CA
Legal business name
SUGIHARA SURGICAL SERVICES INC
Practice address
811 E 11TH St Ste 207
Upland, CA 91786-4872
Phone
(909) 870-3033
Fax
(909) 870-3034
NPI assigned
Aug 17, 2017
Last updated
Sep 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Authorized official

Name
Adam Q Sugihara, MDNPI 1316172836
Title
Physician Owner
Phone
(909) 870-3033

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
Surgery Physician 208600000X A142557 CA Primary

Addresses

Primary practice location

811 E 11TH St Ste 207
Upland, CA 91786-4872

Mailing address

299 W Foothill Blvd Ste 212
Upland, CA 91786-3806
Phone (909) 870-3033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170920001164 CA Part B Supplier - Clinic/Group Practice 9335413996 Receives reassigned benefits from 1 practitioner
Practice locations: Upland, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1063938553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 W FOOTHILL BLVD STE 212",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863806",
            "telephone_number": "909-870-3033",
            "fax_number": "909-870-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E 11TH ST STE 207",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864872",
            "telephone_number": "909-870-3033",
            "fax_number": "909-870-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGIHARA SURGICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-17",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A",
        "authorized_official_last_name": "SUGIHARA",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "909-870-3033",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A142557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.