Premier Medical Group of California

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PREMIER MEDICAL GROUP OF CALIFORNIA

Practice address

901 San Bernardino Rd
Suite 101
Upland, CA 91786-4912

Phone

(562) 236-3432

Fax

(888) 228-3419

NPI assigned

Aug 16, 2016

Organization subpart

No

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

Authorized official

Name

Ythanh D Nguyen, M.D.NPI 1255391181

Title

Partner

Phone

(619) 993-0189

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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

• Ythanh Duy Nguyen, MD

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1255391181
  Medicare reassignment Care Compare group NPD Authorized official
• Sara Khan, MD

  • Hospitalist Physician
  • Upland, CA
  • NPI 1033253414

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Bilal Rafic Rayes, MD

  • Hospitalist Physician
  • Upland, CA
  • NPI 1619095841

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Sadia Fatima Moinuddin, MD

  • Internal Medicine Physician
  • Upland, CA
  • NPI 1912293317
  Medicare reassignment NPD

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1629523014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8816 FOOTHILL BLVD STE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307199",
            "telephone_number": "562-236-3432",
            "fax_number": "888-228-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SAN BERNARDINO RD",
            "address_2": "SUITE 101",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864912",
            "telephone_number": "562-236-3432",
            "fax_number": "888-228-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL GROUP OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "YTHANH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "619-993-0189",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "546306",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precision Hospice Care, Inc.
• Precision Surgical Institute Inc
• Premier Care Hospice Inc
• Premier Hospitalist Group Inc
• Premier Hospitalist Group of California
• Premium Extremity Care, Inc.
• Jonathan Price, D.C.
• Andria Prickett
• Prime Pathways Corporation, Inc.
• Primericare Hospice LLC

• Internal Medicine Physician in Upland, CA
• Providers in Upland, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.