Organization Active NPI

Symonett Family Medical Center Inc

  • Primary Care Clinic/Center
  • Colton, CA
National Provider Identifier
1255692372
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SYMONETT FAMILY MEDICAL CENTER INC
Practice address
1035 S Mount Vernon Ave Ste F
Colton, CA 92324-4207
Phone
(909) 824-1060
Fax
(909) 824-0501
NPI assigned
Jun 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Authorized official

Name
Mr. Elmer Raymond Symonett, M.D.NPI 1144317579
Title
President
Phone
(909) 824-1060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1035 S Mount Vernon Ave Ste F
Colton, CA 92324-4207

Mailing address

1035 S Mount Vernon Ave Ste F
Colton, CA 92324-4207
Phone (909) 824-1060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130522000093 CA Part B Supplier - Clinic/Group Practice 3173761749 Receives reassigned benefits from 1 practitioner
Practice locations: Colton, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0902391Symonett Family Medical Center1035 South Mount Vernon, Suite F, Colton, CA 92324Certificate of waiverJun 18, 2027

National Provider Directory

National Provider Directory

Locations

1035 S Mount Vernon Ave
Ste F
Colton, CA 92324
Phone (909) 824-1060

Practitioners & affiliated clinicians

Practitioners 1

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": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1255692372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 S MOUNT VERNON AVE STE F",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244207",
            "telephone_number": "909-824-1060",
            "fax_number": "909-824-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 S MOUNT VERNON AVE STE F",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244207",
            "telephone_number": "909-824-1060",
            "fax_number": "909-824-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYMONETT FAMILY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "SYMONETT",
        "authorized_official_first_name": "ELMER",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-824-1060",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.