NPIMap

Organization Active NPI

California Medical Clinic Inc

  • Family Medicine Physician
  • Moreno Valley, CA
National Provider Identifier
1326133083
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2DA7091 Issued in CA
Legal business name
CALIFORNIA MEDICAL CLINIC INC
Practice address
23900 Ironwood Ave
Moreno Valley, CA 92557-7151
Phone
(951) 485-2570
Fax
(951) 485-2070
NPI assigned
Oct 4, 2006
Last updated
Sep 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Authorized official

Name
Leland Mathew Luna, DO.
Title
Medical Director
Phone
(909) 467-1605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2DA7091 CA Primary

Addresses

Primary practice location

23900 Ironwood Ave
Moreno Valley, CA 92557-7151

Mailing address

23900 Ironwood Ave
Moreno Valley, CA 92557-7151
Phone (951) 485-2570

Other identifiers 1

IdentifierTypeStateIssuer
8453037MedicaidCA

Other names 1

  • Clinica Medica California Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
California Medical Clinic Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

23900 Ironwood Ave
Moreno Valley, CA 92557
Phone (951) 485-2570

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1326133083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23900 IRONWOOD AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577151",
            "telephone_number": "951-485-2570",
            "fax_number": "951-485-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23900 IRONWOOD AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577151",
            "telephone_number": "951-485-2570",
            "fax_number": "951-485-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "LUNA",
        "authorized_official_first_name": "LELAND",
        "authorized_official_middle_name": "MATHEW",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "909-467-1605",
        "authorized_official_credential": "DO."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "2DA7091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8453037",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Medica California",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.