NPIMap

Individual provider Active NPI

Milton Retamozo, MD

  • Surgery Physician
  • Colton, CA
National Provider Identifier
1174630016
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A79166 Issued in CA
Practice address
400 N Pepper Ave
Dept Surgery Modular # 3
Colton, CA 92324
Phone
(909) 580-3353
Fax
(909) 580-1363
NPI assigned
Aug 24, 2006
Last updated
Sep 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A79166 CA Primary
Vascular Surgery Physician 2086S0129X A79166 CA

Addresses

Primary practice location

400 N Pepper Ave
Dept Surgery Modular # 3
Colton, CA 92324

Mailing address

400 N. Pepper Ave.
Mob Suite 308 Attn Olivia Mendoza
Colton, CA 92324-1801
Phone (909) 580-3353

Other practice location 1

18523 Corwin Rd Ste A
Apple Valley, CA 92307-2300
Phone (909) 712-2764

Other identifiers 1

IdentifierTypeStateIssuer
GR0079700MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060912000632 CA Practitioner - Vascular SurgeryPractitioner - General Surgery 9638173263 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Texas Tech University Health Science Center School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paul J Wisniewski DO IncGroup PAC ID 5092240606, 19 clinicians
Cal Med Physicians and Surgeons IncGroup PAC ID 4385556687, 34 clinicians

Practice addresses (Care Compare)

18523 Corwin Rd
Suite a
Apple Valley, CA 92307-2300
Phone (407) 335-6950

33404 James Stewart Cir
Yucaipa, CA 92399-6437
Phone (407) 335-6950

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-3353

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.52 of 100Reported as group
Quality
97.68
Improvement activities
40
Cost
62.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A79166CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Trauma Surgeons, Inc. CurrentSince May 13, 2021 Accepting new patients
Cal Med Physicians and Surgeons, Inc. Surgery CurrentSince Jul 1, 2006 Accepting new patients
Enloe Medical Center Surgery CurrentSince Aug 25, 2016 Accepting new patients
Paul J Wisniewski DO Inc Surgery CurrentSince Sep 22, 2024 Accepting new patients
Enloe Medical Center CurrentSince Aug 25, 2016 Accepting new patients
Enloe Medical Center Past Accepting new patients

Locations

18523 Corwin Rd
Ste A
Apple Valley, CA 92307
Phone (760) 946-3876

1600 Esplanade
Ste C
Chico, CA 95926
Phone (530) 332-4470

1281 W C St
Ste 200
Colton, CA 92324
Phone (909) 679-2701

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1400

400 N Pepper Ave
#3
Colton, CA 92324
Phone (909) 580-3353

400 N Pepper Ave
Ste 308
Colton, CA 92324
Phone (909) 580-1366

47111 Monroe St
Indio, CA 92201
Phone (760) 347-6191

6601 White Feather Rd
Joshua Tree, CA 92252
Phone (760) 366-1500

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mretamozo18027@armc.direct.summit-healthcare.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1174630016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N. PEPPER AVE.",
            "address_2": "MOB SUITE 308 ATTN OLIVIA MENDOZA",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-3353",
            "fax_number": "909-580-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "DEPT SURGERY MODULAR # 3",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "92324",
            "telephone_number": "909-580-3353",
            "fax_number": "909-580-1363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18523 Corwin Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923072300",
            "country_code": "US",
            "telephone_number": "909-712-2764",
            "fax_number": "909-752-8719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RETAMOZO",
        "first_name": "MILTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A79166",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A79166",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0079700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.