| Cajon Medical Group Pc | |
|
23100 Eucalyptus Ave Ste D Moreno Valley CA 92553-5439 | |
| (909) 735-2446 | |
| (909) 206-1553 |
| Full Name | Cajon Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 23100 Eucalyptus Ave Ste D, Moreno Valley, California |
| Authorized Official Name and Position | Syam P Kunam (CEO) |
| Authorized Official Contact | 9097352446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cajon Medical Group Pc 1809 W Redlands Blvd Redlands CA 92373-8054 Ph: (909) 735-2446 | Cajon Medical Group Pc 23100 Eucalyptus Ave Ste D Moreno Valley CA 92553-5439 Ph: (909) 735-2446 |
| NPI Number | 1841844891 |
|---|---|
| Provider Enumeration Date | 07/29/2019 |
| Last Update Date | 02/11/2022 |
| Medicare PECOS PAC ID | 8820351174 |
|---|---|
| Medicare Enrollment ID | O20190606002315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841844891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lalitha M Vakkalanka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194755959 PECOS PAC ID: 9436177284 Enrollment ID: I20051109001200 |
| Provider Name | Balu Gadhe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740233808 PECOS PAC ID: 9436160975 Enrollment ID: I20060511000215 |
| Provider Name | Mehul S Sonawala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336166180 PECOS PAC ID: 1658473848 Enrollment ID: I20070219000231 |
| Provider Name | Thiruvoipati Nandakumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598773632 PECOS PAC ID: 1355231879 Enrollment ID: I20071023000447 |
| Provider Name | Maria S Garcia-martinez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336198415 PECOS PAC ID: 6406993500 Enrollment ID: I20091103000165 |
| Provider Name | David Montenegro Sapien |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922234889 PECOS PAC ID: 4082801055 Enrollment ID: I20101203000598 |
| Provider Name | Thillaiampalam Srijaerajah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538271002 PECOS PAC ID: 0547228876 Enrollment ID: I20110216000435 |
| Provider Name | Carmela V Ignacio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134563695 PECOS PAC ID: 7315187507 Enrollment ID: I20130711000551 |
| Provider Name | Diana Aurora Uribe-tanus |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1780069054 PECOS PAC ID: 1254648819 Enrollment ID: I20150916001881 |
| Provider Name | Suresh B Hosuru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477782910 PECOS PAC ID: 5092979765 Enrollment ID: I20160502001286 |
| Provider Name | Laurentiu Istrate |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437416179 PECOS PAC ID: 5597990630 Enrollment ID: I20170831003038 |
| Provider Name | Debra Michelle Bogar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962039503 PECOS PAC ID: 9638578883 Enrollment ID: I20210520002227 |
| Provider Name | Cherry P Thangaraj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003584087 PECOS PAC ID: 3577961341 Enrollment ID: I20211008000045 |
| Provider Name | Sachin Kumar Chatta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063906709 PECOS PAC ID: 6002205929 Enrollment ID: I20211116000701 |
| Provider Name | Jesus Pacis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215645122 PECOS PAC ID: 0143690636 Enrollment ID: I20221227001324 |
| Provider Name | Shahla Khan |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1548513567 PECOS PAC ID: 1153786660 Enrollment ID: I20230504001895 |
| Provider Name | Cecilia Jane Fisher |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1457060634 PECOS PAC ID: 1456713437 Enrollment ID: I20230809000668 |
| Provider Name | Ashley O Kehinde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225796683 PECOS PAC ID: 3971947862 Enrollment ID: I20240219003847 |
Riverside University Health System Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 26520 Cactus Ave, Moreno Valley, CA 92555 Phone: 951-486-4000 Fax: 951-486-4435 | |
Antonio A. Tan, Md, Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12980 Frederick St, Suite D, Moreno Valley, CA 92553 Phone: 951-485-2744 Fax: 951-485-2749 | |
Dong S. Kim, M.d., Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11441 Heacock St, Ste. F, Moreno Valley, CA 92557 Phone: 951-243-8000 Fax: 951-243-9707 | |
Planned Parenthood Pacific Southwest Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12900 Frederick St Ste C, Moreno Valley, CA 92553 Phone: 951-222-3101 | |
Joel A Pengson, Md, A Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 23180 Hemlock Ave, Moreno Valley, CA 92557 Phone: 951-243-6460 | |
John Liquete Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14114 Business Center Dr, Suite D, Moreno Valley, CA 92553 Phone: 951-697-1150 | |
Yogendra B Patel,md,inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12980 Frederick St, Suite J, Moreno Valley, CA 92553 Phone: 951-924-9300 Fax: 951-485-0240 |