Organization Active NPI

San Bernardino Physicians Associates, a Medical Corporation

  • Family Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1487752895
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAN BERNARDINO PHYSICIANS ASSOCIATES, A MEDICAL CORPORATION
Practice address
407 E Gilbert St Ste 1
San Bernardino, CA 92404-5325
Phone
(909) 889-1136
Fax
(909) 889-2816
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Authorized official

Name
Octavio Ruiz-Villalpando, M.D.
Title
Medical Director/ Owner
Phone
(909) 889-1136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

407 E Gilbert St Ste 1
San Bernardino, CA 92404-5325

Mailing address

407 E Gilbert St Ste 1
San Bernardino, CA 92404-5325
Phone (909) 889-1136

Other names 1

  • San Bernardino Clinica Medica Familiar Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0926673San Bernardino Clinica Medica407 E Gilbert Ave Ste 1, San Bernardino, CA 92404Certificate of waiverJun 17, 2028

National Provider Directory

National Provider Directory

Locations

407 E Gilbert St
Ste 1
Sn Bernrdno, CA 92404
Phone (909) 889-1136

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1487752895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E GILBERT ST STE 1",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045325",
            "telephone_number": "909-889-1136",
            "fax_number": "909-889-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E GILBERT ST STE 1",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045325",
            "telephone_number": "909-889-1136",
            "fax_number": "909-889-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN BERNARDINO PHYSICIANS ASSOCIATES, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "RUIZ-VILLALPANDO",
        "authorized_official_first_name": "OCTAVIO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/ OWNER",
        "authorized_official_telephone_number": "909-889-1136",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Bernardino Clinica Medica Familiar",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.