Cardinal Medical Center, Inc
Organization Active NPI Geriatric Medicine (Family Medicine) Physician · Bonsall, CA
NPI 1396924205 · NPPES record last updated Jun 10, 2025
Key facts
- NPI
- 1396924205
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Geriatric Medicine (Family Medicine) Physician 207QG0300X
- License
- A43808 (CA)
- Legal business name
- CARDINAL MEDICAL CENTER, INC
- Practice address
- 31457 Lake Vista Cir
Bonsall, CA 92003-5308 - Phone
- (760) 717-3450
- NPI assigned
- Oct 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Gina Pinhiero
- Title
- Administrator
- Phone
- (714) 403-0199
Practitioners 2
-
Jeffrey L. Newman, M.D.
-
Angelica D. Mendez, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080229000139 | CA | Part B Supplier - Clinic/Group Practice | 3577647569 |
Receives reassigned benefits from 1 practitioner Practice locations: Bonsall, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | A43808 | CA | |
| Geriatric Medicine (Family Medicine) Physician |
207QG0300X | A43808 | CA | Yes |
Addresses
Primary practice location
31457 Lake Vista Cir
Bonsall, CA 92003-5308
Mailing address
31457 Lake Vista Cir
Bonsall, CA 92003-5308
Phone (760) 941-8888
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W21766 | Other | CA | MEDICARE PTAN |
| 00A438080 | Medicaid | CA |
Other providers in Bonsall, CA
- Connie Darlene Bagley
- Ginger Bahardar
- Bonsall Unified School District
- Karen Boymoushakian
- C. Greg Henderson DC Inc a Chiropractic Corporation
- Randy Dennis Carlson
- Christensen Sicat Hsu, DDS Inc.
- Cierra Gratz Speech and Language Pathology
- Jennifer Attridge Claudin
- Clearwater Wellness and Development LLC
All providers in Bonsall, CA · Geriatric Medicine (Family Medicine) Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.