Juan Cornell

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

336425651 Issued in CA

Practice address

1622 Palermo Dr
Riverside, CA 92507-2393

Phone

(562) 685-4610

Fax

(951) 213-6898

NPI assigned

Aug 20, 2018

Last updated

Aug 20, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eagel Time Care Facility

  • Lodging Provider
  • Riverside, CA
  • NPI 1922768431
  NPD Authorized official
• The Emmanuel Project

  • Lodging Provider
  • Riverside, CA
  • NPI 1609559228
  Authorized official Same address or phone

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1790265650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 PALERMO DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072393",
            "telephone_number": "562-685-4610",
            "fax_number": "951-213-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 PALERMO DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072393",
            "telephone_number": "562-685-4610",
            "fax_number": "951-213-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "JUAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "336425651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Cornejo
• Stephanie Cornejo
• Ronald Cornelissen
• Nadin Cornelius-Martin
• Traci Cornelius
• Cornerstone Surgery Center & Anesthesia Nursing Services Inc. (Cornerstone Surgery Center Inc.)
• Adrian Corona-Pimentel
• Sigrid Viveros Corona
• Valentina Corona
• Corona/Riverside Health Clinic

• Assisted Living Facility in Riverside, CA
• Providers in Riverside, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.