NPIMap

Organization Active NPI

Vanguard Medical Corporation

  • Rural Health Clinic/Center
  • Arvin, CA
National Provider Identifier
1942970124
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
VANGUARD MEDICAL CORPORATION
Practice address
1100 Bear Mountain Blvd
Arvin, CA 93203
Phone
(661) 459-1020
Fax
(661) 459-3535
NPI assigned
Sep 17, 2021
Last updated
Jun 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Authorized official

Name
Novira Sunner
Title
Administrator
Phone
(661) 599-5310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

1100 Bear Mountain Blvd
Arvin, CA 93203

Mailing address

565 Kern St
Shafter, CA 93263-2133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140813002697 CA Part B Supplier - Clinic/Group Practice 4587881685 Receives reassigned benefits from 33 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arvin, CA; Bakersfield, CA; Shafter, CA; Wasco, CA
O20220607003269 CA Part A Provider - Rural Health Clinic 4587881685 Practice locations: Arvin, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942970124. Details of each certification follow.

Rural health clinic certification: CCN 558912

Legal name
VANGUARD MEDICAL CORPORATION
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 26, 2023
Last certification
Sep 26, 2023
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Apr 30, 2014 in CA
Enrollment address
1100 Bear Mountain Blvd
Arvin, CA 93203-1345

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2280327Vanguard Medical Corporation1100 Bear Mountain Blvd, Arvin, CA 93203Certificate of waiverApr 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Vanguard Medical Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Novira P Sunner Individual Operational/Managerial ControlAdministrator Apr 30, 2014 20%
Chan Park Individual 5% Or Greater Direct Ownership Interest Apr 30, 2014 100%
Corporate OfficerCeo Apr 30, 2014 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

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": "1631836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1942970124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 KERN ST",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BEAR MOUNTAIN BLVD",
            "city": "ARVIN",
            "state": "CA",
            "postal_code": "93203",
            "telephone_number": "661-459-1020",
            "fax_number": "661-459-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-17",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "SUNNER",
        "authorized_official_first_name": "NOVIRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "661-599-5310"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvin, CA

Sources for this page

Verify at the official NPI Registry.