Southern California Permanente Medical Group

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

Practice address

393 E Walnut St Regional Behavioral Health FL 2
Pasadena, CA 91188-0001

Phone

(877) 608-0049

NPI assigned

Oct 5, 2022

Last updated

Oct 5, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Maria Villarosa

Title

Assistant Regional Medical Director

Phone

(951) 809-5364

Specialties & licenses 1

Addresses

Electronic endpoints 1

Tax ID family

Southern California Permanente Medical Group5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Kaiser Permanente

  • Clinic/Center
  • Oxnard, CA
  • NPI 1811367436
  NPD tax ID
• Rioh Medical Group

  • General Practice Physician
  • Redding, CA
  • NPI 1548205826
  NPD tax ID
• Southern California Permanente Medical Group

  • Clinical Medical Laboratory
  • Los Angeles, CA
  • NPI 1124269717
  NPD tax ID
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1609446814
  NPD tax ID

Locations

Practitioners 1

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.

• Mary Grace Balbuena Sosing

  • Clinical Social Worker
  • Pasadena, CA
  • NPI 1538642418
  NPD

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1780309468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E WALNUT ST REGIONAL BEHAVIORAL HEALTH FL 2",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911880001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E WALNUT ST REGIONAL BEHAVIORAL HEALTH FL 2",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911880001",
            "telephone_number": "877-608-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "VILLAROSA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "ASSISTANT REGIONAL MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-809-5364",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Southern California Home Medical, Services, Inc (Home Medical Supplies)
• Southern California Infusion Therapy, Inc.
• Southern California Internists Medical Group
• Southern California Mental Health Associates
• Southern California Neurology Medical Group, Inc.
• Southern California Pioneer Health PC
• Southern California Psychodiagnostics, LLC
• Southern California Surgical Specialists, Inc
• Southern California Surgical Specialists, Inc.
• Southern California TMS Center Inc

• Health Maintenance Organization in Pasadena, CA
• Providers in Pasadena, 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 Oct 5, 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.