NPIMap

Organization Active NPI

Faro T. Owiesy, M.D., Inc

Doing business as Corona Doctors Medical Clinic

  • Family Medicine Physician
  • Corona, CA
National Provider Identifier
1891724886
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A87796 Issued in CA
Legal business name
FARO T. OWIESY, M.D., INC
Doing business as
Corona Doctors Medical Clinic
Practice address
802 Magnolia Ave
Suite 106
Corona, CA 92879-3125
Phone
(951) 371-9500
Fax
(951) 371-9194
NPI assigned
Jul 2, 2006
Last updated
Dec 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Authorized official

Name
Dr. Faro T. Owiesy, M.DNPI 1568464048
Title
Medical Director
Phone
(951) 371-9500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A87796 CA Primary

Addresses

Primary practice location

802 Magnolia Ave
Suite 106
Corona, CA 92879-3125

Mailing address

802 Magnolia Ave
Suite 106
Corona, CA 92879-3104
Phone (951) 371-9500

Other names 1

  • CORONA DOCTORS MEDICAL CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060727000424 CA Part B Supplier - Clinic/Group Practice 0042223661 Receives reassigned benefits from 1 practitioner
Practice locations: Corona, CA

National Provider Directory

National Provider Directory

Locations

1820 Fullerton Ave
Ste 120
Corona, CA 92881
Phone (951) 371-4400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1891724886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 MAGNOLIA AVE",
            "address_2": "SUITE 106",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793104",
            "telephone_number": "951-371-9500",
            "fax_number": "951-371-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 MAGNOLIA AVE",
            "address_2": "SUITE 106",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793125",
            "telephone_number": "951-371-9500",
            "fax_number": "951-371-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARO T. OWIESY, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "OWIESY",
        "authorized_official_first_name": "FARO",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-371-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A87796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORONA DOCTORS MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.