Organization Active NPI

Rancho Cucamonga Perpetual Help Medical Corporation

  • Family Medicine Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1215909130
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A47994 Issued in CA
Legal business name
RANCHO CUCAMONGA PERPETUAL HELP MEDICAL CORPORATION
Practice address
8112 Milliken Ave Ste 100
Rancho Cucamonga, CA 91730-7472
Phone
(909) 466-6410
Fax
(909) 466-5667
NPI assigned
Feb 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Authorized official

Name
Florencia T Tampoya, MD
Title
Physician Owner
Phone
(909) 466-6410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A47994 CA Primary

Addresses

Primary practice location

8112 Milliken Ave Ste 100
Rancho Cucamonga, CA 91730-7472

Mailing address

8112 Milliken Ave Ste 100
Rancho Cucamonga, CA 91730-7472
Phone (909) 466-6410

Other identifiers 2

IdentifierTypeStateIssuer
GR0101410MedicaidCA
ZZZ07974ZOtherCABLUE SHIELD #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081124000055 CA Part B Supplier - Clinic/Group Practice 1557329794 Receives reassigned benefits from 2 practitioners
Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1138924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1215909130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8112 MILLIKEN AVE STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307472",
            "telephone_number": "909-466-6410",
            "fax_number": "909-466-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8112 MILLIKEN AVE STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307472",
            "telephone_number": "909-466-6410",
            "fax_number": "909-466-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCHO CUCAMONGA PERPETUAL HELP MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-03",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "TAMPOYA",
        "authorized_official_first_name": "FLORENCIA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "909-466-6410",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A47994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0101410",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "ZZZ07974Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.