Organization Active NPI

Ramona Medical Clinic

  • Geriatric Medicine (Internal Medicine) Physician
  • San Jacinto, CA
National Provider Identifier
1528049095
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A45395 Issued in CA
Legal business name
RAMONA MEDICAL CLINIC
Practice address
341 E Main St
San Jacinto, CA 92583-4231
Phone
(951) 654-9367
Fax
(951) 654-0839
NPI assigned
Nov 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
Dr. Neelam Gupta, M.D.NPI 1922289628
Title
Physician
Phone
(951) 654-9367

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A45395 CA
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X A45395 CA Primary

Addresses

Primary practice location

341 E Main St
San Jacinto, CA 92583-4231

Mailing address

341 E Main St
San Jacinto, CA 92583-4231
Phone (951) 654-9367

Other identifiers 1

IdentifierTypeStateIssuer
GR0082550MedicaidCA

National Provider Directory

National Provider Directory

Locations

341 E Main St
San Jacinto, CA 92583
Phone (951) 654-5590

Practitioners & affiliated clinicians

Practitioners 2

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": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1528049095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 E MAIN ST",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925834231",
            "telephone_number": "951-654-9367",
            "fax_number": "951-654-0839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 E MAIN ST",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925834231",
            "telephone_number": "951-654-9367",
            "fax_number": "951-654-0839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAMONA MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "NEELAM",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "951-654-9367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A45395",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A45395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0082550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jacinto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.