NPIMap

Organization Active NPI

Rancho Family Medical Group, Inc.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1518782002
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RANCHO FAMILY MEDICAL GROUP, INC.
Practice address
4060 Fourth Ave Ste 100
San Diego, CA 92103-2120
Phone
(619) 718-9444
NPI assigned
Nov 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
R. Eric Madrid
Title
Chief Medical Officer
Phone
(951) 676-4193

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4060 Fourth Ave Ste 100
San Diego, CA 92103-2120

Mailing address

41923 2ND St Ste 204
Temecula, CA 92590-2833

Other names 1

  • San Diego Medical Group Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rancho Family Medical G5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

41923 2nd St
Ste 204
Temecula, CA 92590

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1518782002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41923 2ND ST STE 204",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 FOURTH AVE STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032120",
            "telephone_number": "619-718-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCHO FAMILY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "MADRID",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "951-676-4193"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Medical Group Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.