Ephraim Litonjua Sanmiguel Jr., P.A.C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13252 Issued in CA

Practice address

2295 S Vineyard Ave
BLDG a Primary Care 2ND Floor
Ontario, CA 91761-7925

Phone

(888) 750-0036

Fax

(909) 264-2266

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1316463763
  NPD

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1871712034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 S VINEYARD AVE",
            "address_2": "BLDG A PRIMARY CARE 2ND FLOOR",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617925",
            "telephone_number": "888-750-0036",
            "fax_number": "909-264-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 S VINEYARD AVE",
            "address_2": "BLDG A PRIMARY CARE 2ND FLOOR",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617925",
            "telephone_number": "888-750-0036",
            "fax_number": "909-264-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANMIGUEL",
        "first_name": "EPHRAIM",
        "middle_name": "LITONJUA",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.A.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED LIC NUMBER",
            "identifier": "PA13252",
            "state": "CA"
        }
    ],
    "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": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rocio Sandoval
• Sophia Alicia Sandoval
• Terri Mae Sandoval, APRN, CNS-N, MSN, RN
• Leona Sandrik
• Kyla Sands
• Leon Alfred Santa Cruz, PA
• Santa Rita Medical Center
• Carol Santacruz, BCBA
• Cynthia Santana
• Madeline Santana

• Physician Assistant in Ontario, CA
• Providers in Ontario, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.