NPIMap

Organization Active NPI

Community Care Mobile Doctors

  • Family Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1750029690
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMUNITY CARE MOBILE DOCTORS
Practice address
275 W Hospitality LN Ste 314
San Bernardino, CA 92408-3265
Phone
(956) 245-2275
NPI assigned
May 20, 2022
Last updated
May 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Authorized official

Name
Joel ZamoraNPI 1750432852
Title
Secretary
Phone
(909) 810-0185

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

275 W Hospitality LN Ste 314
San Bernardino, CA 92408-3265

Mailing address

275 W Hospitality LN Ste 314
San Bernardino, CA 92408-3265
Phone (956) 245-2275

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL comminitycaremd@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220630001170 CA Part B Supplier - Clinic/Group Practice 8325428857 Receives reassigned benefits from 18 practitioners
Practice locations: San Bernardino, CA

National Provider Directory

National Provider Directory

Locations

275 W Hospitality Ln
Ste 314
Sn Bernrdno, CA 92408
Phone (956) 245-2275

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1750029690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W HOSPITALITY LN STE 314",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083265",
            "telephone_number": "956-245-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W HOSPITALITY LN STE 314",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083265",
            "telephone_number": "956-245-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE MOBILE DOCTORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "909-810-0185"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "comminitycaremd@gmail.com",
            "affiliation": "N",
            "address_1": "275 W Hospitality Ln Ste 314",
            "city": "San Bernardino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "924083265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; 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.