Exordium Medical Group, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EXORDIUM MEDICAL GROUP, INC

Practice address

412 E State St
Redlands, CA 92373-5237

Phone

(909) 908-4844

NPI assigned

Mar 4, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Shan Singh Dhillon, DONPI 1053864116

Title

Co-Owner

Phone

(909) 709-9149

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23063/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Shan Singh Dhillon, DO

  • Internal Medicine Physician
  • Redlands, CA
  • NPI 1053864116

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1215522941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 124",
            "city": "MENTONE",
            "state": "CA",
            "postal_code": "923590124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 E STATE ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735237",
            "telephone_number": "909-908-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXORDIUM MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "DHILLON",
        "authorized_official_first_name": "SHAN",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "909-709-9149",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Redlands, CA
• Providers in Redlands, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.