Morongo Medical Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A426710 Issued in CA

Legal business name

MORONGO MEDICAL GROUP INC

Practice address

57725 29 Palms Hwy
Ste 401
Yucca Valley, CA 92284-3044

Phone

(760) 228-1929

Fax

(760) 228-9633

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Prem P Salhotra, MDNPI 1457302812

Title

President

Phone

(760) 228-1929

Specialties & licenses 1

Addresses

Other identifiers 3

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

Locations

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 7

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

• Prem P Salhotra, M.D.

  • Internal Medicine Physician
  • Yucca Valley, CA
  • NPI 1457302812
  Medicare reassignment NPD Authorized official
• Mi la Kim, FNP

  • Family Nurse Practitioner
  • Yucaipa, CA
  • NPI 1295047058
  Medicare reassignment NPD
• Marilyn Yu, MD

  • Family Medicine Physician
  • Yucca Valley, CA
  • NPI 1649328428
  NPD
• Victor Tung, DO

  • Family Medicine Physician
  • Huntington Beach, CA
  • NPI 1710914544

  Internal Medicine

  NPD (past)
• Sagar Bedi, MD

  • Emergency Medicine Physician
  • Sunnyvale, TX
  • NPI 1366556441
  NPD (past)
• Robyn Michele Erhardt, NP

  • Family Nurse Practitioner
  • Sarasota, FL
  • NPI 1366413395
  NPD (past)
• Varun Gupta, MD

  • Hematology & Oncology Physician
  • Palm Springs, FL
  • NPI 1669433306
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1972644516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1809",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922861809",
            "telephone_number": "760-228-1929",
            "fax_number": "760-228-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57725 29 PALMS HWY",
            "address_2": "STE 401",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922843044",
            "telephone_number": "760-228-1929",
            "fax_number": "760-228-9633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "72724 29 Palms Hwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Twentynine Palms",
            "state": "CA",
            "postal_code": "922772459",
            "country_code": "US",
            "telephone_number": "760-367-9531",
            "fax_number": "206-350-7191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MORONGO MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "SALHOTRA",
        "authorized_official_first_name": "PREM",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-228-1929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A426710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078500",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP NO",
            "identifier": "CE7451",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZ53804AZ",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matt Gabriel Moran, N.P.
• Allison K Moreno
• Charlotte Louise Morgan
• Morongo Basin Mental Health Services Assoc Inc
• Morongo Basin OB/GYN Medical Group Inc
• Peter Martin Morris
• Sandy Moua
• Linda J Murphy, LPCC
• Clarice Murray
• German Peter Musch, MD

• Internal Medicine Physician in Yucca Valley, CA
• Providers in Yucca Valley, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.