NPIMap

Organization Active NPI

Californi Medical Clinic Inc

  • Family Medicine Physician
  • Fontana, CA
National Provider Identifier
1215022918
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CALIFORNI MEDICAL CLINIC INC
Practice address
16701 Valley Blvd
Fontana, CA 92335-6696
Phone
(909) 467-1605
Fax
(909) 467-1608
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Authorized official

Name
Leland Mathew Luna, DO
Title
Medical Director
Phone
(909) 467-1605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

16701 Valley Blvd
Fontana, CA 92335-6696

Mailing address

16701 Valley Blvd
Fontana, CA 92335-6696
Phone (909) 467-1605

Other identifiers 1

IdentifierTypeStateIssuer
5095137MedicaidCA

Other names 1

  • Clinic Medica California Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Californi Medical Clinic Inc2 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.

Locations

937 S Alvarado St
Ste 1D
Los Angeles, CA 90006
Phone (213) 263-2950

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1215022918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16701 VALLEY BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356696",
            "telephone_number": "909-467-1605",
            "fax_number": "909-467-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16701 VALLEY BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356696",
            "telephone_number": "909-467-1605",
            "fax_number": "909-467-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNI MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "LUNA",
        "authorized_official_first_name": "LELAND",
        "authorized_official_middle_name": "MATHEW",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "909-467-1605",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5095137",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinic Medica California",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.