NPIMap

Organization Active NPI

Cajon Medical Group PC

  • Internal Medicine Physician
  • Redlands, CA
National Provider Identifier
1326547183
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAJON MEDICAL GROUP PC
Practice address
1815 W Redlands Blvd
Redlands, CA 92373-8054
Phone
(909) 289-4075
Fax
(909) 363-8233
NPI assigned
Feb 7, 2018
Last updated
Feb 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Authorized official

Name
Syam P Kunam
Title
Ceo
Phone
(909) 735-2446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1815 W Redlands Blvd
Redlands, CA 92373-8054

Mailing address

1809 W Redlands Blvd
Redlands, CA 92373-8054
Phone (951) 500-2121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190606002315 CA Part B Supplier - Clinic/Group Practice 8820351174 Receives reassigned benefits from 33 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Redlands, CA; Yucaipa, CA; Wildomar, CA; Victorville, CA; Upland, CA; Temecula, CA; San Bernardino, CA; Riverside, CA…

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory
Tax ID family
Cajon Medical Group PC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

9278 N Loop Blvd
California City, CA 93505
Phone (760) 373-4809

12555 Central Ave
Chino, CA 91710

5475 Walnut Ave
#2
Chino, CA 91710

5475 Walnut Ave
Ste 2
Chino, CA 91710

81709 Doctor Carreon Blvd
Ste Ci
Indio, CA 92201

31571 Canyon Estates Dr
Ste 124
Lake Elsinore, CA 92532
Phone (951) 676-2119

23110 Atlantic Cir
Ste E
Moreno Valley, CA 92553
Phone (951) 243-6455

23110 Eucalyptus Ave
Moreno Valley, CA 92553

23119 Cottonwood Ave
Moreno Valley, CA 92553
Phone (951) 413-5130

1738 N Waterman Ave
Ste 107
San Bernardino, CA 92404

1738 N Waterman Ave
Ste 8
San Bernardino, CA 92404

1738 N Waterman Ave
Ste 7
Sn Bernrdno, CA 92404
Phone (909) 557-0135

34675 Yucaipa Blvd
Ste 107
Yucaipa, CA 92399

34675 Yucaipa Blvd
Ste 107108
Yucaipa, CA 92399

34675 Yucaipa Blvd
Ste 108107
Yucaipa, CA 92399

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1326547183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 W REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738054",
            "telephone_number": "951-500-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 W REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738054",
            "telephone_number": "909-289-4075",
            "fax_number": "909-363-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAJON MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-07",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "KUNAM",
        "authorized_official_first_name": "SYAM",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-735-2446"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.