Optum Care Network-Inland Faculty MG

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

44334241 Issued in CA

Legal business name

OPTUM CARE NETWORK-INLAND FACULTY MG

Practice address

952 S Mount Vernon Ave Ste B
Colton, CA 92324-4224

Phone

(909) 433-9111

Fax

(909) 433-9199

NPI assigned

Nov 20, 2006

Organization subpart

No

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

Authorized official

Name

Valdemar Lucatero

Title

Ipa-Operations Manager

Phone

(909) 815-4702

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1750455713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 S MOUNT VERNON AVE STE B",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "952 S MOUNT VERNON AVE STE B",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244224",
            "telephone_number": "909-433-9111",
            "fax_number": "909-433-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM CARE NETWORK-INLAND FACULTY MG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "LUCATERO",
        "authorized_official_first_name": "VALDEMAR",
        "authorized_official_title_or_position": "IPA-OPERATIONS MANAGER",
        "authorized_official_telephone_number": "909-815-4702"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "44334241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Thien Ong
• Harriet Semo Ongondo
• Onsite Services of California
• Thet Naing Oo, MD
• Shane William Oostinga
• Derek Andrew Orchard, D.O.
• Tania Paola Ordaz
• Noemi Ordona
• Michea Oring
• Cherechi Promise Orji

• Health Maintenance Organization in Colton, CA
• Providers in Colton, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.