NPIMap

Organization Active NPI

California University of Science and Medicine

  • Neurology Physician
  • Colton, CA
National Provider Identifier
1255849360
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
CALIFORNIA UNIVERSITY OF SCIENCE AND MEDICINE
Practice address
400 N Pepper Ave
Colton, CA 92324-1801
Phone
(855) 422-8029
Fax
(855) 422-8029
NPI assigned
Jan 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Authorized official

Name
Paul Lyons, MDNPI 1588652515
Title
Ceo/President
Phone
(909) 566-2669

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0006X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

400 N Pepper Ave
Colton, CA 92324-1801

Mailing address

1501 Violet St
Colton, CA 92324-1603
Phone (909) 566-2669

Other names 1

  • CUSM Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180608001920 CA Part B Supplier - Clinic/Group Practice 4880949106 Receives reassigned benefits from 14 practitioners
Practice locations: Colton, CA; Riverside, CA

National Provider Directory

National Provider Directory

Locations

1501 Violet St
Colton, CA 92324
Phone (909) 580-9661

4646 Brockton Ave
Ste 302
Riverside, CA 92506
Phone (951) 682-6900

4646 Brockton Ave
Ste 302-2
Riverside, CA 92506
Phone (951) 742-5255

217 E Club Center Dr
Ste A
San Bernardino, CA 92408

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1255849360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 VIOLET ST",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241603",
            "telephone_number": "909-566-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "855-422-8029",
            "fax_number": "855-422-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA UNIVERSITY OF SCIENCE AND MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "909-566-2669",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUSM Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 19, 2020; 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.