NPIMap

Individual provider Active NPI

Mowbray Philip Hagan, MD

  • Internal Medicine Physician
  • Corona, CA
National Provider Identifier
1235145590
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A29431 Issued in CA
Practice address
760 Washburn Ave Ste 4
Corona, CA 92882-3303
Phone
(951) 734-6110
Fax
(951) 734-9989
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A29431 CA Primary

Addresses

Primary practice location

760 Washburn Ave Ste 4
Corona, CA 92882-3303

Mailing address

760 Washburn Ave Ste 4
Corona, CA 92882-3303
Phone (951) 734-6110

Other identifiers 1

IdentifierTypeStateIssuer
00A294310MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050325000640 CA Practitioner - Internal Medicine 1052376365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 1974
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

482 Corona Mall
Corona, CA 92879-1418
Phone (951) 734-6110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A29431CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mowbray P Hagan, MD, Inc Current Accepting new patients
Mowbray P. Hagan, M.D. Inc. CurrentSince May 24, 2004 Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Uhs Corona Inc Past Accepting new patients
Eminence Centers for Health PastSince Jun 1, 2023 Accepting new patients

Locations

760 Washburn Ave
Ste 4
Corona, CA 92882
Phone (951) 734-6110

482 Corona Mall
Corona, CA 92879
Phone (951) 549-9791

500 Corona Mall
Corona, CA 92879
Phone (951) 734-6110

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northeast Billing GroupNorco, CA, CCN A01794 Hospice Contracted Managing Employee Jun 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1235145590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 WASHBURN AVE STE 4",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823303",
            "telephone_number": "951-734-6110",
            "fax_number": "951-734-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WASHBURN AVE STE 4",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823303",
            "telephone_number": "951-734-6110",
            "fax_number": "951-734-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "MOWBRAY",
        "middle_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A29431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A294310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.