Hesperia Clinica Medica Familiar a Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A92039 Issued in CA

Legal business name

HESPERIA CLINICA MEDICA FAMILIAR A MEDICAL CORPORATION

Doing business as

Hesperia Clinica Medica Familiar A Medical Corporation

Practice address

15888 Main St
Suite 112B
Hesperia, CA 92345-3467

Phone

(760) 948-2242

Fax

(760) 948-6244

NPI assigned

Jan 28, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Octavio Ruiz-Villalpando, M.D.NPI 1194832816

Title

Owner/President

Phone

(760) 948-2242

Specialties & licenses 1

Addresses

Other names 1

• Hesperia Clinica Medica Familiar A Medical Corporation Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 4

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

• Octavio Ruiz-Villalpando, MD

  • Family Medicine Physician
  • Perris, CA
  • NPI 1194832816
  Medicare reassignment NPD Authorized official
• Sandra Limon, NP

  • Nurse Practitioner
  • Hesperia, CA
  • NPI 1316493406
  Medicare reassignment NPD
• Don Pham, DO

  • General Practice Physician
  • Hesperia, CA
  • NPI 1992184998
  Medicare reassignment NPD
• William C Inciso, PA-C, PHD

  • Physician Assistant
  • San Bernardino, CA
  • NPI 1407050289
  Medicare reassignment

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1164728788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15888 MAIN ST",
            "address_2": "SUITE 112B",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923453467",
            "telephone_number": "760-948-2242",
            "fax_number": "760-948-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15888 MAIN ST",
            "address_2": "SUITE 112B",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923453467",
            "telephone_number": "760-948-2242",
            "fax_number": "760-948-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HESPERIA CLINICA MEDICA FAMILIAR A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "RUIZ-VILLALPANDO",
        "authorized_official_first_name": "OCTAVIO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "760-948-2242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A92039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hesperia Clinica Medica Familiar A Medical Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maye Hernandez
• Stephanie Hernandez
• Abigail Herrera
• Samantha Herrera
• Kenneth Herrick, NP
• Hesperia Dental Center Inc.
• Hesperia Fire Protection District (Hesperia Fire Department)
• Hesperia la Salle Pharmacy
• Hesperia Physical Therapy Inc.
• Hesperia Unified School District

• Family Medicine Physician in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; 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.