Southern California Physician Network, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SOUTHERN CALIFORNIA PHYSICIAN NETWORK, INC

Practice address

2250 S Main St Ste 201
Corona, CA 92882-2536

Phone

(951) 621-3232

Fax

(951) 882-6967

NPI assigned

Dec 30, 2014

Last updated

May 17, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Nduati

Title

President

Phone

(951) 200-7385

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 11

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.

• Amy Lee Aguilar

  • Family Nurse Practitioner
  • Corona, CA
  • NPI 1790319796
  Medicare reassignment Care Compare group NPD
• Samantha Merchant Hum, NP

  • Family Nurse Practitioner
  • Corona, CA
  • NPI 1922610450
  Medicare reassignment Care Compare group NPD
• L R Roberto Moscoso, M.D.

  • Cardiovascular Disease Physician
  • Corona, CA
  • NPI 1073548962
  Medicare reassignment Care Compare group NPD
• William Myoungwon Suh, MD

  • Cardiovascular Disease Physician
  • Corona, CA
  • NPI 1740200351

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Babak Yasmeh, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Corona, CA
  • NPI 1417392622
  Medicare reassignment Care Compare group NPD
• Samantha Benin, MD, MPH

  • Cardiovascular Disease Physician
  • Boca Raton, FL
  • NPI 1396241915

  CA, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Srinidhi Ekkati, PA-C

  • Medical Physician Assistant
  • Corona, CA
  • NPI 1316108491
  Medicare reassignment Care Compare group
• Sara Atif Godil, MD

  • Cardiovascular Disease Physician
  • Bonita, CA
  • NPI 1316439060
  Medicare reassignment Care Compare group
• Michael John Austen, MD

  • Family Medicine Physician
  • Bradenton, FL
  • NPI 1154513364
  NPD (past)
• Mario E Litano, M.D.

  • General Practice Physician
  • Bradenton, FL
  • NPI 1841326345
  NPD (past)
• Asha Munshi, M.D.

  • Family Medicine Physician
  • Bradenton, FL
  • NPI 1346271699
  NPD (past)

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1083002075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3046",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193550746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST STE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822536",
            "telephone_number": "951-621-3232",
            "fax_number": "951-882-6967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA PHYSICIAN NETWORK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-30",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "NDUATI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-200-7385",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083002075",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "CA307699",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Soule
• South Corona Chiropractic Center
• South Corona Chiropractic Center Inc
• Deborah South, OTR
• Southcoronachiropracticcenter
• Southland Arthrites and Osteoporosis Medical Center Inc
• Southwestern Transportation Management Services
• Souza Medical Group Inc
• Space Cat DB LLC (SCDB LLC)
• Special Service for Groups, Inc.

• Internal Medicine Physician in Corona, CA
• Providers in Corona, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.