Individual provider Active NPI

Sa'D Khalil Tuqan, M.D.

  • Cardiovascular Disease Physician
  • Corona, CA
National Provider Identifier
1629030895
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
C37812 Issued in CA
Practice address
2250 S Main St
Suite 201
Corona, CA 92882-5302
Phone
(951) 734-4880
Fax
(951) 734-7963
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X C37812 CA Primary

Addresses

Primary practice location

2250 S Main St
Suite 201
Corona, CA 92882-5302

Mailing address

1901 Town and Country Dr
Ste 104
Norco, CA 92860-3611
Phone (951) 808-6240

Other identifiers 1

IdentifierTypeStateIssuer
00C378120MedicaidCA

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
I20080702000275 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1153493481 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C37812CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Heart Doctors Medical Group Cardiovascular Disease CurrentSince Jan 1, 1989 Accepting new patients
Circle City Ekg Reading Panel,Inc CurrentSince Mar 20, 2009 Accepting new patients
Corona Health Specialty Associates, LLC Cardiovascular Disease CurrentSince Aug 1, 2022 Accepting new patients
Uhs Corona Inc Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients

Locations

2250 S Main St
Ste 205
Corona, CA 92882
Phone (951) 734-2900

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

854 Magnolia Ave
Ste 201
Corona, CA 92879
Phone (951) 356-5414

2250 S Main St
Ste 201
Corona, CA 92882
Phone (951) 621-3232

1901 Town and Country Dr
Ste 104
Norco, CA 92860
Phone (951) 737-8141

940 N Haven Ave
Ste 18025
Ontario, CA 91764

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1629030895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 TOWN AND COUNTRY DR",
            "address_2": "STE 104",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603611",
            "telephone_number": "951-808-6240",
            "fax_number": "951-738-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST",
            "address_2": "SUITE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825302",
            "telephone_number": "951-734-4880",
            "fax_number": "951-734-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUQAN",
        "first_name": "SA'D",
        "middle_name": "KHALIL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "C37812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C378120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.