Individual provider Active NPI

Arnold Estera Magbanua, M.D.

  • Family Medicine Physician
  • Banning, CA
National Provider Identifier
1831203439
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A83612 Issued in CA
Practice address
11555 1/2 Potrero Rd
Banning, CA 92220-6946
Phone
(951) 849-4761
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A83612 CA Primary

Addresses

Primary practice location

11555 1/2 Potrero Rd
Banning, CA 92220-6946

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (951) 849-4761

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150612001284 TX Practitioner - Family Practice 3779712765 Reassigns benefits to 1 organization
I20160318000940 CA Practitioner - Family Practice 3779712765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

14305 Meridian Pkwy
Riverside, CA 92518-3034
Phone (951) 251-7300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83612CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Oct 30, 2022 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. Current Accepting new patients
Beaver Medical Group P C CurrentSince Feb 2, 2016 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 30, 2022 Accepting new patients
Beaver Medical Group P C Family Medicine CurrentSince Feb 2, 2016 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. CurrentSince Feb 1, 2015 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc CurrentSince Feb 1, 2015 Accepting new patients

Locations

11555 Potrero Rd
Banning, CA 92220
Phone (800) 732-8805

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

2 W Fern Ave
Redlands, CA 92373
Phone (909) 786-0725

2 W Fern Ave
#1112
Redlands, CA 92373

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1831203439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "951-849-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 1/2 POTRERO RD",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922206946",
            "telephone_number": "951-849-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGBANUA",
        "first_name": "ARNOLD",
        "middle_name": "ESTERA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A83612",
            "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": []
}

Other providers in Banning, CA

Sources for this page

Verify at the official NPI Registry.