Superior Family Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SUPERIOR FAMILY MEDICAL GROUP INC

Practice address

1419 Superior Ave
1
Newport Beach, CA 92663-2723

Phone

(949) 650-0587

Fax

(949) 631-8155

NPI assigned

Dec 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Rafael Rafael Penunuri, MD

Title

President

Phone

(949) 650-0587

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Rafael Arturo Penunuri, M.D.

  • Internal Medicine Physician
  • Newport Beach, CA
  • NPI 1831270362

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1568645653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 SUPERIOR AVE",
            "address_2": "1",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926632723",
            "telephone_number": "949-650-0587",
            "fax_number": "949-631-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 SUPERIOR AVE",
            "address_2": "1",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926632723",
            "telephone_number": "949-650-0587",
            "fax_number": "949-631-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR FAMILY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "PENUNURI",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "RAFAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-650-0587",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunny Park MD, Inc
• Sunrise Healing Non-Profit, Inc
• Sunset Shoreline
• Sunset Shores Recovery
• George Gregory Super, M.D.
• Superior Performance Physical Therapy PC
• Superior Psychiatric Services
• Superior Surgery Center
• Superior Surgery Center
• Superior TMS Center

• Family Medicine Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.