Individual provider Active NPI

Lailae Furutan, MD

  • Internal Medicine Physician
  • Highland, CA
National Provider Identifier
1912952771
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A76474 Issued in CA
Practice address
7223 Church St
Highland, CA 92346-5869
Phone
(909) 862-1191
Fax
(909) 796-4158
NPI assigned
May 23, 2006
Last updated
Jun 1, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A76474 CA Primary

Addresses

Primary practice location

7223 Church St
Highland, CA 92346-5869

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 793-3311

Other identifiers 1

IdentifierTypeStateIssuer
00A764741MedicaidCA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081205000288 CA Practitioner - Internal Medicine 5395806640 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
76474CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
A76474CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Medical Group P C CurrentSince Dec 11, 2001 Accepting new patients
Beaver Medical Group P C Internal Medicine CurrentSince Dec 11, 2001 Accepting new patients
Healthcare Partners Affiliates Medical Group Internal Medicine Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2024 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

7223 Church St
Ste C
Highland, CA 92346

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1912952771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-793-3311",
            "fax_number": "909-796-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7223 CHURCH ST",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923465869",
            "telephone_number": "909-862-1191",
            "fax_number": "909-796-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FURUTAN",
        "first_name": "LAILAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A76474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A764741",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, CA

Sources for this page

Verify at the official NPI Registry.