Organization Active NPI

MD Zuniga Inc.

Doing business as Edge Family Medicine

  • Family Medicine Physician
  • Upland, CA
National Provider Identifier
1073262929
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MD ZUNIGA INC.
Doing business as
Edge Family Medicine
Practice address
440 N Mountain Ave Ste 110
Upland, CA 91786-5183
Phone
(909) 870-5200
Fax
(909) 870-5188
NPI assigned
Mar 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Authorized official

Name
Mike Zuniga, M.D.NPI 1578791588
Title
Ceo
Phone
(909) 870-5200

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

440 N Mountain Ave Ste 110
Upland, CA 91786-5183

Mailing address

440 N Mountain Ave Ste 110
Upland, CA 91786-5183
Phone (909) 870-5200

Other names 1

  • Edge Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220708003453 CA Part B Supplier - Clinic/Group Practice 6507246477 Receives reassigned benefits from 3 practitioners
Practice locations: Upland, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2288731MD Zuniga, Inc. Edge Family Medicine440 N Mountain Avenue Suite 110, Upland, CA 91786Certificate of waiverAug 28, 2027

National Provider Directory

National Provider Directory

Locations

440 N Mountain Ave
Upland, CA 91786
Phone (909) 949-2881

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1647648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1073262929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N MOUNTAIN AVE STE 110",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865183",
            "telephone_number": "909-870-5200",
            "fax_number": "909-870-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 N MOUNTAIN AVE STE 110",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865183",
            "telephone_number": "909-870-5200",
            "fax_number": "909-870-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD ZUNIGA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-19",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "ZUNIGA",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-870-5200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edge Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.