NPIMap

Individual provider Active NPI

Serafin Tambaoan Lalas Jr., M.D.

  • Psychiatry Physician
  • Loma Linda, CA
National Provider Identifier
1700050515
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A113532 Issued in CA
Practice address
24949 Prospect Street
Loma Linda, CA 92354-2804
Phone
(909) 677-8072
NPI assigned
Apr 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A113532 CA Primary

Addresses

Primary practice location

24949 Prospect Street
Loma Linda, CA 92354-2804

Mailing address

24949 Prospect Street
Loma Linda, CA 92354-2804
Phone (909) 677-8072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121112000490 CA Practitioner - Psychiatry 2264683648 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11370 Anderson St
Loma Linda, CA 92354-3450

1686 Barton Rd
Redlands, CA 92373-1488
Phone (909) 558-9551

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
113532CAMDMarriage & Family Therapist
A113532CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Dec 30, 2013 Accepting new patients
Sac Health System CurrentSince Nov 1, 2021 Accepting new patients
Sac Health System Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Psychiatry CurrentSince Dec 30, 2013 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System CurrentSince Nov 1, 2021 Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatry Current Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatry CurrentSince Oct 21, 2012 Accepting new patients
Integrated Mind, Inc. Psychiatry Past Accepting new patients

Locations

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

8710 Monroe Ct
Ste 150
Rancho Cucamonga, CA 91730
Phone (909) 941-4870

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Interoperability endpoints

  • Direct secure messaging: slalas8508@direct.llu.edu

Organizations & group practices 9

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": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1700050515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24949 PROSPECT STREET",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-677-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24949 PROSPECT STREET",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-677-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALAS",
        "first_name": "SERAFIN",
        "middle_name": "TAMBAOAN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-14",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A113532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.