Lake Elsinore Clinica Medica Familiar a Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A92039 Issued in CA

Legal business name

LAKE ELSINORE CLINICA MEDICA FAMILIAR A MEDICAL CORPORATION

Practice address

31739 Riverside Dr
Suite a-1
Lake Elsinore, CA 92530-7818

Phone

(951) 245-0505

Fax

(951) 245-0999

NPI assigned

Oct 1, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Octavio Ruiz-Villalpando, M.D.NPI 1194832816

Title

President

Phone

(951) 245-0505

Specialties & licenses 1

Addresses

Other names 1

• Lake Elsinore Clinica Medica Familiar Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Octavio Ruiz-Villalpando, MD

  • Family Medicine Physician
  • Perris, CA
  • NPI 1194832816
  Medicare reassignment Authorized official
• Philip Anthony Delgado, D.O.

  • Family Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1235355942
  Medicare reassignment
• Frank Pastor, PA

  • Physician Assistant
  • Pomona, CA
  • NPI 1871530931
  Medicare reassignment
• David Monarrez, MD

  • General Practice Physician
  • Corona, CA
  • NPI 1770512287
  NPD (past)

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1851625396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31739 RIVERSIDE DR",
            "address_2": "SUITE A-1",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307818",
            "telephone_number": "951-245-0505",
            "fax_number": "951-245-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31739 RIVERSIDE DR",
            "address_2": "SUITE A-1",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307818",
            "telephone_number": "951-245-0505",
            "fax_number": "951-245-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ELSINORE CLINICA MEDICA FAMILIAR A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "RUIZ-VILLALPANDO",
        "authorized_official_first_name": "OCTAVIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-245-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A92039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Elsinore Clinica Medica Familiar",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kun Bai Business Inc.
• Sandar Kyi, MD
• Tera Labrosciano, M.A., CCC-SLP
• Debra D Lacy
• Kaleb Can Lai
• Lake Elsinore Congregate Care Inc.
• Lake Elsinore Diagnostics
• Lake Elsinore Unified School District
• Lake Elsinore Urgent Care Center
• Lakeshore Medical Clinic Inc

• Family Medicine Physician in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.