Orange Psychiatric Medical Group, Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

ORANGE PSYCHIATRIC MEDICAL GROUP, INC

Practice address

4000 14TH St
Suite 310a
Riverside, CA 92501-4018

Phone

(951) 276-1100

Fax

(951) 276-1105

NPI assigned

Jul 20, 2012

Last updated

Jul 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sai B Chundu, M.D.NPI 1609968460

Title

President/ Owner

Phone

(951) 737-1917

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

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

• Orange Psychiatric Medical Group, Inc

  • Psychiatry Physician
  • Corona, CA
  • NPI 1225383763

  O20121126000504

  Same enrollment
• Orange Psychiatric Medical Group, Inc

  • Psychiatry Physician
  • Murrieta, CA
  • NPI 1386999829

  O20121126000504

  Same enrollment
• Orange Psychiatric Medical Group, Inc

  • Psychiatry Physician
  • Temecula, CA
  • NPI 1396090742

  O20121126000504

  Same enrollment
• Orange Psychiatric Medical Group, Inc

  • Psychiatry Physician
  • Murrieta, CA
  • NPI 1659626109

  O20121126000504

  Same enrollment

Practitioners 1

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.

• Sai Chundu, MD

  • Psychiatry Physician
  • Corona, CA
  • NPI 1609968460
  Authorized official Same address or phone

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342742400000",
    "number": "1205181757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 MAGNOLIA AVE",
            "address_2": "SUITE 1F",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793121",
            "telephone_number": "951-737-1917",
            "fax_number": "951-735-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 14TH ST",
            "address_2": "SUITE 310A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014018",
            "telephone_number": "951-276-1100",
            "fax_number": "951-276-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE PSYCHIATRIC MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-20",
        "status": "A",
        "authorized_official_last_name": "CHUNDU",
        "authorized_official_first_name": "SAI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "951-737-1917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optimize Emotional Intelligence Clinical Social Worker, Inc. (Optimize Emotional Intelligence)
• Optimum Care CLHF 2, LLC
• Optimum Care Ie, LLC
• Oracle Imaging Inc. (Oracle Imaging Center)
• Orange County Hospice Services, Inc. (Loma Linda University Hospice)
• Orange Tree Therapeutic Alliance, a LCSW Corporation (Orange Tree Therapeutic Alliance / OTTA Therapy)
• Orange Treeidence Opco, LLC (Riverwalk Post Acute)
• Alonta Orange
• Orangecrest Medical Group, Inc.
• Orangetree Convalescent Hospital, LLC

• Psychiatry Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.