Individual provider Active NPI

Ciara Catherine Bautista Fulgar, DO

  • Internal Medicine Physician
  • Moreno Valley, CA
National Provider Identifier
1467193664
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A22185 Issued in CA
Practice address
26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone
(951) 486-4000
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 20A22185 CA Primary

Addresses

Primary practice location

26520 Cactus Ave
Moreno Valley, CA 92555-3927

Mailing address

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-5000

Other practice location 1

11234 Anderson Street
GME Office Westerly Suite C
Loma Linda, CA 92354-2804
Phone (909) 558-4074

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250717002672 CA Practitioner - HospitalistPractitioner - Internal Medicine 6507372596 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faculty Physicians and Surgeons of LlusmGroup PAC ID 1153227814, shared by 6 NPIs, 1,313 clinicians
Riverside Faculty Medical Group IncGroup PAC ID 9436253515, 76 clinicians

Practice addresses (Care Compare)

11370 Anderson St
Loma Linda, CA 92354-3450

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 656-1500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A22185CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Faculty Medical Group Inc Internal Medicine CurrentSince Jul 1, 2025 Accepting new patients
County of Riverside CurrentSince Jul 1, 2025 Accepting new patients
County of Riverside CurrentSince Jul 1, 2025 Accepting new patients
County of Riverside Current Accepting new patients

Locations

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

26600 Cactus Ave
Ste 300
Moreno Valley, CA 92555
Phone (800) 720-9553

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

Interoperability endpoints

  • Direct secure messaging: cfulgar539648@direct.llu.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1467193664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson Street",
            "address_2": "GME Office Westerly Suite C",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULGAR",
        "first_name": "CIARA CATHERINE",
        "middle_name": "BAUTISTA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A22185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.