Sotara Manalo Rico Professional Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOTARA MANALO RICO PROFESSIONAL MEDICAL CORPORATION

Practice address

5253 Riverside Dr
Chino, CA 91710-4151

Phone

(909) 464-2845

Fax

(909) 464-2848

NPI assigned

Jun 15, 2017

Organization subpart

No

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

Authorized official

Name

Sotara Manalo Rico, D.O.NPI 1962654392

Title

Owner

Phone

(909) 464-2845

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 2

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

• Sotara Manalo Rico, D.O.

  • Family Medicine Physician
  • Chino, CA
  • NPI 1962654392
  Medicare reassignment Care Compare group NPD Authorized official
• Amber Beth Moryl, MS, MPAS, PA-C

  • Physician Assistant
  • Chino, CA
  • NPI 1467880229
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1962932632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 LAS LUNAS ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061302",
            "telephone_number": "925-457-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5253 RIVERSIDE DR",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104151",
            "telephone_number": "909-464-2845",
            "fax_number": "909-464-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOTARA MANALO RICO PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-15",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "RICO",
        "authorized_official_first_name": "SOTARA",
        "authorized_official_middle_name": "MANALO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-464-2845",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Chino, CA
• Providers in Chino, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.