Individual provider Active NPI

Benedict James San Jose Malinao, FNP-C

  • Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1336698018
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95029695 Issued in CA
Practice address
4646 Brockton Ave Ste 202
Riverside, CA 92506-0104
Phone
(951) 774-2942
Fax
(951) 774-2945
NPI assigned
Sep 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95029695 CA Primary

Addresses

Primary practice location

4646 Brockton Ave Ste 202
Riverside, CA 92506-0104

Mailing address

3386 Fallenleaf Dr
Corona, CA 92882-8781
Phone (229) 220-4406

Other practice location 1

11882 De Palma Rd Ste 2F-1
Corona, CA 92883-4008
Phone (951) 603-3335

Other practice location 2

15944 Los Serranos Country Club Dr Ste 200
Chino Hills, CA 91709-3991
Phone (909) 903-2330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260317002764 CA Order and Referring Only - Nurse Practitioner 3375873714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN204584GAMDRegistered Nurse
95029695CAMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: benedict.malinao@49412312072196.direct.elationemr.com

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1336698018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3386 FALLENLEAF DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928828781",
            "telephone_number": "229-220-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 BROCKTON AVE STE 202",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060104",
            "telephone_number": "951-774-2942",
            "fax_number": "951-774-2945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11882 De Palma Rd Ste 2F-1",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928834008",
            "country_code": "US",
            "telephone_number": "951-603-3335",
            "fax_number": "909-799-2008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15944 Los Serranos Country Club Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chino Hills",
            "state": "CA",
            "postal_code": "917093991",
            "country_code": "US",
            "telephone_number": "909-903-2330",
            "fax_number": "909-799-2008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALINAO",
        "first_name": "BENEDICT JAMES",
        "middle_name": "SAN JOSE",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-23",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95029695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.