Organization Active NPI

Corona Physicians Associates, a Medical Corp

  • Family Medicine Physician
  • Corona, CA
National Provider Identifier
1891899175
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CORONA PHYSICIANS ASSOCIATES, A MEDICAL CORP
Practice address
217 E 3Rd St
Corona, CA 92879-1438
Phone
(951) 273-1188
Fax
(951) 284-5602
NPI assigned
Sep 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Authorized official

Name
Octavio Ruiz-Villalpando, M.D.
Title
Medical Director
Phone
(951) 273-1188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

217 E 3Rd St
Corona, CA 92879-1438

Mailing address

217 E 3Rd St
Corona, CA 92879-1438
Phone (951) 273-1188

Other names 1

  • Corona Clinica Medica Familiar Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080125000173 CA Part B Supplier - Clinic/Group Practice 7911005897 Receives reassigned benefits from 1 practitioner
Practice locations: Corona, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1891899175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 E 3RD ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791438",
            "telephone_number": "951-273-1188",
            "fax_number": "951-346-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E 3RD ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791438",
            "telephone_number": "951-273-1188",
            "fax_number": "951-284-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONA PHYSICIANS ASSOCIATES, A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "RUIZ-VILLALPANDO",
        "authorized_official_first_name": "OCTAVIO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-273-1188",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corona Clinica Medica Familiar",
            "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 Aug 17, 2015; 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.