NPIMap

Organization Active NPI

Sun Medical Group, Inc

  • Urgent Care Clinic/Center
  • Ladera Ranch, CA
National Provider Identifier
1114588704
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
SUN MEDICAL GROUP, INC
Practice address
27522 Antonio Pkwy Ste P3
Ladera Ranch, CA 92694-2166
Phone
(714) 337-9393
NPI assigned
Jun 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Miranda De Luna, MDNPI 1023235819
Title
Medical Director
Phone
(316) 214-7764

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

27522 Antonio Pkwy Ste P3
Ladera Ranch, CA 92694-2166

Mailing address

PO Box 519
Lake Forest, CA 92609-0519
Phone (949) 207-3786

Other names 1

  • AFC Ladera RAnch Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190927001371 CA Part B Supplier - Clinic/Group Practice 8426388810 Receives reassigned benefits from 31 practitioners
1 other NPI on this enrollment
Practice locations: Anaheim, CA; Ladera Ranch, CA
O20220712000154 CA DME Supplier - Physician - Family Practice 8426388810 Practice locations: Ladera Ranch, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
05D2179963Sun Medical Group, Inc27522 Antonio Parkway Suite P3, Ladera Ranch, CA 92694Certificate of waiverMar 3, 2028

National Provider Directory

National Provider Directory

Locations

27522 Antonio Pkwy
Ste P3
Ladera Ranch, CA 92694
Phone (949) 207-3786

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1114588704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 519",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926090519",
            "telephone_number": "949-207-3786",
            "fax_number": "949-216-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27522 ANTONIO PKWY STE P3",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942166",
            "telephone_number": "714-337-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-24",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "DE LUNA",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "316-214-7764",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AFC Ladera RAnch",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AFC Ladera RAnch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ladera Ranch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.