Organization Active NPI

A.M. Palanca-Capistrano,M.D. Inc.

  • Clinic/Center
  • Corona, CA
National Provider Identifier
1194947200
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
A91568 Issued in CA
Legal business name
A.M. PALANCA-CAPISTRANO,M.D. INC.
Practice address
720 Magnolia Avenue
Suite a-4
Corona, CA 92879
Phone
(951) 372-9227
Fax
(951) 372-9005
NPI assigned
May 2, 2007
Last updated
Feb 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Authorized official

Name
Dr. Angelita M. Palanca-Capistrano, M.D.NPI 1578526521
Title
President
Phone
(951) 372-9227

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X A91568 CA Primary

Addresses

Primary practice location

720 Magnolia Avenue
Suite a-4
Corona, CA 92879

Mailing address

19069 Van Buren Blvd
Ste. 114-219
Riverside, CA 92508-9169
Phone (951) 372-9227

Other identifiers 1

IdentifierTypeStateIssuer
1585438MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070612000836 CA Part B Supplier - Clinic/Group Practice 7113025222 Receives reassigned benefits from 3 practitioners
Practice locations: Corona, CA; Moreno Valley, 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
05D2043947A.M. Palanca - Capistrano, MD720 Magnolia Ave Ste A4, Corona, CA 92879Certificate of waiverJul 12, 2026

National Provider Directory

National Provider Directory
Tax ID family
Ampalanca-Capistranomdinc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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 3

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": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1194947200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19069 VAN BUREN BLVD",
            "address_2": "STE. 114-219",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925089169",
            "telephone_number": "951-372-9227",
            "fax_number": "951-372-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 MAGNOLIA AVENUE",
            "address_2": "SUITE A-4",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92879",
            "telephone_number": "951-372-9227",
            "fax_number": "951-372-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A.M. PALANCA-CAPISTRANO,M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "PALANCA-CAPISTRANO",
        "authorized_official_first_name": "ANGELITA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-372-9227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A91568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1585438",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.