Organization Active NPI

Abc Medical Corporation

  • Urgent Care Clinic/Center
  • Hemet, CA
National Provider Identifier
1174803043
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ABC MEDICAL CORPORATION
Practice address
1701 E Florida Ave
Hemet, CA 92544-4632
Phone
(951) 652-2228
Fax
(951) 925-1026
NPI assigned
Aug 24, 2011
Last updated
Aug 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Authorized official

Name
Anil Rastogi, MD
Title
Cfo
Phone
(951) 652-2228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

1701 E Florida Ave
Hemet, CA 92544-4632

Mailing address

1275 E Latham Ave Ste a
Hemet, CA 92543-4424
Phone (951) 652-2228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120508000494 CA Part B Supplier - Clinic/Group Practice 5193987121 Receives reassigned benefits from 1 practitioner
Practice locations: Hemet, CA

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
05D2051893Abc Medical Corporation1701 E Florida Ave, Hemet, CA 92544Certificate of waiverJan 1, 2027

National Provider Directory

National Provider Directory

Locations

1701 E Florida Ave
Hemet, CA 92544
Phone (951) 652-2228

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1174803043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 E LATHAM AVE STE A",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434424",
            "telephone_number": "951-652-2228",
            "fax_number": "951-925-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E FLORIDA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925444632",
            "telephone_number": "951-652-2228",
            "fax_number": "951-925-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "RASTOGI",
        "authorized_official_first_name": "ANIL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "951-652-2228",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.