ORANGECREST MEDICAL GROUP, INC. (NPI# 1033676317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033676317 |
| Entity Type | Organization |
| Organization Name | ORANGECREST MEDICAL GROUP, INC. |
| Practice Address |
14200 Meridian Pkwy Ste 101 Riverside CA 92518-3044 |
| Mailing Address |
4646 Brockton Ave Ste 203 Riverside CA 92506-0104 |
| Practice Telephone | 9516530655 |
| Practice Fax Number | 9516530664 |
| Mailing Telephone | 9517742881 |
| Mailing Fax Number | 9517742846 |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2020-04-22 |
| Authorized Official Name | DEBORAH NOVELLINO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9517742881 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ARTICLES OF INCORPORATION | 4232015 | 01 |
| Street Address |
14200 MERIDIAN PKWY STE 101 |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92518-3044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720603301 | William Donald | Emergency Medical Technician, Paramedic | March Air Reserve Base, Moreno Valley, CA 92518 | 2020-06-10 |
| 1861011876 | Monika Ellyn Garcia | Student in an Organized Health Care Education/Training Program | 14350 Meridian Parkway Box #2, Riverside, CA 92518 | 2020-04-09 |
| 1558906164 | Jasmine Feely | Registered Nurse | 5770 Riverside Dr Bldg 601, 752 Medical Squadron, March Arb, CA 92518 | 2019-11-07 |
| 1952957375 | April Blum | Nurse Practitioner | 14200 Meridian Parkway, # 101, Riverside, CA 92518 | 2019-08-12 |
| 1902463094 | Dale Timothy Hoang | Student in an Organized Health Care Education/Training Program | 14350-2 Meridian Pkwy, Riverside, CA 92518 | 2019-05-23 |
| 1619534716 | Karen Stacy Clarey | Student in an Organized Health Care Education/Training Program | 14350-2 Meridian Parkway, Riverside, CA 92518 | 2019-05-23 |
| 1528548070 | Holly Stevenson | Registered Nurse | 5770 Riverside Dr., Bldg 601, 752d Medical Squadron, March Arb, CA 92518 | 2018-08-15 |
| 1275058026 | James Lee Mitchener IIi | Registered Nurse | 5770 Riverside Drive, Building 601, 752 Medical Squadron, March Arb, CA 92518 | 2017-08-12 |
| 1710400239 | Dominique B. Horne | Registered Nurse | 5770 Riverside Dr. Bldg 601, 752 Medical Squadron, March Arb, CA 92518 | 2017-07-18 |
| 1891150918 | Irene Peralta | Registered Nurse | 770 Riverside Dr., Bldg 601, March Arb, CA 92518 | 2015-12-16 |
| Find all providers in zip 92518 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700309689 | Lumina Family Care, Inc. | Family Medicine | 6780 Indiana Ave Ste 110, Riverside, CA 92506-4284 | 2017-07-21 |
| 1730613019 | Iman Fobia | Family Medicine | 1971 University Avenue, Riverside, CA 92507 | 2017-04-13 |
| 1992189286 | Inpatient Consultants of California, Inc | Family Medicine | 7177 Brockton Ave Ste 217, Riverside, CA 92506-2633 | 2015-07-16 |
| 1376920116 | Koohzad Karimi | Family Medicine | 445 Magnolia Avenue, Riverside, CA 92501 | 2015-04-30 |
| 1528474103 | Ivy Cao | Family Medicine | 1971 University Ave, Family Medicine Department, Riverside, CA 92507 | 2014-07-03 |
| 1417372533 | John Mcdevitt | Family Medicine | 3550 Lillian St, Riverside, CA 92504-3609 | 2014-02-26 |
| 1972861797 | Central Occupational Medicine Providers Ontario Inc | Family Medicine | 4300 Central Ave, Riverside, CA 92506-2918 | 2012-04-30 |
| 1619241767 | Inpatient Consultants of California, Inc | Family Medicine | 3610 Central Ave Ste 205, Riverside, CA 92506-5905 | 2012-03-06 |
| 1437438033 | George Samir Nagib | Family Medicine | 7140 Indiana Ave., Riverside, CA 92504-3927 | 2011-08-12 |
| 1902193170 | Metate Medical, Inc. | Family Medicine | 3538 Central Ave, Suite 110, Riverside, CA 92506-2731 | 2011-07-07 |
| Find all providers in RIVERSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.