Individual provider Active NPI

Stephen Homan, D.O.

  • Emergency Medicine Physician
  • Wildomar, CA
National Provider Identifier
1104976661
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A12755 Issued in CA
Practice address
36485 Inland Valley Dr
Wildomar, CA 92595-9681
Phone
(951) 677-1111
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 4515 AZ
Emergency Medicine Physician 207P00000X 20A12755 CA Primary

Addresses

Primary practice location

36485 Inland Valley Dr
Wildomar, CA 92595-9681

Mailing address

36485 Inland Valley Dr
Wildomar, CA 92595-9681
Phone (951) 677-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131022002357 CA Practitioner - Emergency Medicine 1456505361 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Em Alliance California ApcGroup PAC ID 1951749894, 68 clinicians

Practice addresses (Care Compare)

36485 Inland Valley Dr
Wildomar, CA 92595-9681
Phone (951) 677-1111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4515AZMDPeriodontist
20A12755CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Dec 1, 2013 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Dec 1, 2013 Accepting new patients
Em Alliance California, Apc Emergency Medicine CurrentSince Jul 12, 2024 Accepting new patients
Encinitas Emergency Medicine, Inc. Emergency Medicine CurrentSince Jul 5, 2022 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Kalamazoo Emergency Associates, PLC Emergency Medicine Past Accepting new patients

Locations

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

354 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 230-2251

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

25500 Medical Center Dr
Murrieta, CA 92562
Phone (951) 696-6000

38600 Medical Center Dr
Palmdale, CA 93551
Phone (661) 382-5000

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

36485 Inland Valley Dr
Wildomar, CA 92595
Phone (909) 677-9778

L4421
Columbus, OH 43260

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1104976661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36485 INLAND VALLEY DR",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959681",
            "telephone_number": "951-677-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36485 INLAND VALLEY DR",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959681",
            "telephone_number": "951-677-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMAN",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "AZ",
            "license": "4515",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A12755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

Verify at the official NPI Registry.