Adelaide Abiemo, PAC
Individual provider Active NPI Physician Assistant · Lake Elsinore, CA
NPI 1295900280 · NPPES record last updated Nov 12, 2025
Key facts
- NPI
- 1295900280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA 19613 (CA)
- Practice address
- 425 Diamond Dr Ste 104&105
Lake Elsinore, CA 92530-4495 - Phone
- (951) 674-8779
- Fax
- (951) 674-1403
- NPI assigned
- Apr 29, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Healthcare Partners Affiliates Medical Group
Practice addresses (Care Compare)
16800 Lakeshore Dr
Suite 2
Lake Elsinore, CA 92530-4909
Phone (909) 605-8000
425 Diamond Dr
Suite 104And105
Lake Elsinore, CA 92530-4495
Phone (951) 674-8779
5957 W Ramsey St
Banning, CA 92220-3058
Phone (951) 845-0313
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150921001994 | CA | Practitioner - Physician Assistant | 6901817683 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19613 | CA | MD | Clinical Psychologist |
| PA 19613 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthcare Partners Affiliates Medical Group | Current |
Accepting new patients | |
| Inland Urgent Care a Medical Corporation | Current |
Accepting new patients | |
| Aliuddin Khaja, MD., Inc | Past | Accepting new patients | |
| Prime Healthcare Centinela, LLC | Past | Accepting new patients |
Locations
1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000
5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864
31588 Railroad Canyon Rd
Canyon Lake, CA 92587
2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600
824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706
425 Diamond Dr
Ste 104105
Lake Elsinore, CA 92530
Phone (951) 674-8779
1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611
36320 Inland Valley Dr
Ste 307
Wildomar, CA 92595
Phone (909) 600-0110
Interoperability endpoints
- aabiemo25812@epiclp.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 19613 | CA | Yes |
Addresses
Primary practice location
425 Diamond Dr Ste 104&105
Lake Elsinore, CA 92530-4495
Mailing address
PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203
Other practice location 1
575 E Hardy St
205
Inglewood, CA 90301-4036
Phone (310) 275-7575
Other names
- Essi Bakari
Other providers in Lake Elsinore, CA
- 721 Trucking Inc
- A Plus Walk-in Urgent Care Medical Clinic, Apc
- A Rincon DDS Inc
- Abc Home Medical Supply, Inc
- Michael Abrams
- Judith Acosta
- John Addae
- Starla Affatati
- Pheona Aggrey-Carthy
All providers in Lake Elsinore, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.