Physician Management Services of California, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PHYSICIAN MANAGEMENT SERVICES OF CALIFORNIA, LLC

Practice address

4646 Brockton Ave
Riverside, CA 92506-0102

Phone

(888) 829-8550

NPI assigned

Sep 11, 2020

Organization subpart

Yes

Parent organization

VAXCARE CORPORATIONAs reported in NPPES

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

Authorized official

Name

Brett Kenefick

Title

President

Phone

(888) 829-8550

Specialties & licenses 1

Addresses

Part of

Vaxcare Corporation

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Vaxcare LLC

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1316058217

  Member Of

  NPD member

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1871108381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 LAWTON RD STE 250",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060102",
            "telephone_number": "888-829-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN MANAGEMENT SERVICES OF CALIFORNIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAXCARE CORPORATION",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "KENEFICK",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-829-8550"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Joy Phongdara, N.P.
• Lena Phoukatam
• Phuong Nguyet Phun
• Diane Phung
• Phuong C. Huynh, DDS, Inc.
• Physician Partners Medical Group Inc
• Physio Kai Sports Performance & Physical Therapy
• Gary Piascik, MFTI
• Kimberly Picasso
• Cristian Picazo

• Family Medicine Physician in Riverside, CA
• Providers in Riverside, 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 Sep 11, 2020; 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.