C Damirchi M D Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

C DAMIRCHI M D INC

Practice address

355 E 21St St Ste F
San Bernardino, CA 92404-4851

Phone

(909) 886-5251

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Scarlette Damirchi

Title

Administrator

Phone

(949) 933-7639

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Ponteah Damirchi, MD

  • Family Medicine Physician
  • Vista, CA
  • NPI 1134861339
  Medicare reassignment NPD
• Cyrus Damirchi, M.D.

  • Family Medicine Physician
  • San Bernardino, CA
  • NPI 1891883401
  Medicare reassignment

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1639267644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 E 21ST ST STE F",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044851",
            "telephone_number": "909-886-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E 21ST ST STE F",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044851",
            "telephone_number": "909-886-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C DAMIRCHI M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "DAMIRCHI",
        "authorized_official_first_name": "SCARLETTE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "949-933-7639"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khala Butler
• Makeda Shenay Butler
• Heather M Butterfield
• Cameron Byrum
• Brittany Bzovy
• Holly Caballero
• Isaac Caballero
• John Gilbert Caballero Jr.
• Lauren Mae Caballero
• Ismail Cabaravdic

• Family Medicine Physician in San Bernardino, CA
• Providers in San Bernardino, 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 Oct 23, 2024; 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.