Ennis Zaitoon, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C160730 Issued in CA

Practice address

21634 Retreat Pkwy
Corona, CA 92883-6100

Phone

(951) 493-6870

Fax

(951) 826-8157

NPI assigned

Feb 13, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lorian Health Home health agency, Riverside, CA, CCN 059464
• Bridge Home Health Home health agency, Murrieta, CA, CCN 559145

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Riverside Medical Clinic, Inc

  • Dermatology Physician
  • Riverside, CA
  • NPI 1720183403
  Medicare reassignment Care Compare group NPD
• Riverside Medical Clinic, Inc

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1730180415
  NPD
• Riverside Medical Clinic, Inc

  • Family Medicine Physician
  • Eastvale, CA
  • NPI 1972845535

  Internal Medicine

  NPD
• Franciscan Hammond Clinic LLC

  • Internal Medicine Physician
  • Munster, IN
  • NPI 1861791782
  NPD (past)

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

• Bridge Home Health Riverside LLC

  • Home Health Agency
  • Murrieta, CA
  • NPI 1174092423
  Care Compare affiliation
• Lorian Health

  • Home Health Agency
  • Riverside, CA
  • NPI 1578882833
  Care Compare affiliation

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1235307141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21634 RETREAT PKWY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928836100",
            "telephone_number": "951-493-6870",
            "fax_number": "951-826-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21634 RETREAT PKWY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928836100",
            "telephone_number": "951-493-6870",
            "fax_number": "951-826-8157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7905 Calumet Ave",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463211215",
            "country_code": "US",
            "telephone_number": "219-836-5800",
            "fax_number": "219-836-8073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAITOON",
        "first_name": "ENNIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-13",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01067223",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C160730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200963970",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jun Yuan, M.D.
• Edward Jeku Yun, MD
• Yvonne D'Sylva M.D,Inc
• Gary Alan Yzaguirre
• Ryan Angelo Zabalerio, ATC
• Michelle Lautfy Zaki, D.O.
• Susan Zaki, RPA (CBRPA), R.T.
• Matthew Zaky
• Veronica Zaldivar
• Josefina Limjoco Zalvidea, RD

• Internal Medicine Physician in Corona, CA
• Providers in Corona, 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 Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.