SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP (NPI# 1316463763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316463763 |
| Entity Type | Organization |
| Organization Name | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| Other Organization Name | TARGET CLINIC MEDICAL ASSOCIATES OF SOUTHERN CALIFORNIA |
| Practice Address |
15272 Summit Ave Fontana CA 92336-0231 |
| Mailing Address |
393 E Walnut St Fl 3 Pasadena CA 91188-0001 |
| Practice Telephone | 8776080044 |
| Mailing Telephone | 8776080044 |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2017-08-17 |
| Authorized Official Name | EDWARD M ELLISON (EXECUTIVE MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8776080044 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302R00000X | Health Maintenance Organization | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| TARGET CLINIC MEDICAL ASSOCIATES OF SOUTHERN CALIFORNIA | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982863783 | Southern California Permanente Medical Group | Health Maintenance Organization | 43112 N 15th St, Lancaster, CA 93534-6219 | 2008-06-06 |
| 1275756652 | Southern California Permanente Medical Group | Health Maintenance Organization | 2103 E Gonzales Rd, Oxnard, CA 93036-3757 | 2007-04-11 |
| 1891873303 | Southern California Permanente Medical Group | Clinical Medical Laboratory | 11668 Sherman Way, N Hollywood, CA 91605-5831 | 2006-11-01 |
| 1861424376 | Southern California Permanente Medical Group | Health Maintenance Organization | 3733 San Dimas St, Bakersfield, CA 93301-1407 | 2006-07-07 |
| 1316572753 | Southern California Permanente Medical Group | Health Maintenance Organization | 9100 Rosedale Hwy, Bakersfield, CA 93312-2143 | 2020-03-05 |
| 1821635079 | Southern California Permanente Medical Group | Health Maintenance Organization | 3471 W Century Blvd, Inglewood, CA 90303-1218 | 2019-12-06 |
| 1316409410 | Southern California Permanente Medical Group | Health Maintenance Organization | 19105 Golden Valley Rd, Santa Clarita, CA 91387-1428 | 2019-04-05 |
| 1942787114 | Southern California Permanente Medical Group | Health Maintenance Organization | 3600 Rosemead Blvd, Rosemead, CA 91770-2066 | 2018-07-20 |
| 1164914115 | Southern California Permanente Medical Group | Health Maintenance Organization | 2700 W 120th St, Hawthorne, CA 90250-3388 | 2018-06-05 |
| 1013409036 | Southern California Permanente Medical Group | Health Maintenance Organization | 8999 Balboa Blvd, Northridge, CA 91325-2608 | 2018-06-05 |
| Street Address |
15272 SUMMIT AVE |
| City | FONTANA |
| State | CA |
| Zip Code | 92336-0231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811053796 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 15272 Summit Ave, Fontana, CA 92336-0231 | 2006-12-28 |
| 1083009286 | Shihhui Sophie Tsou | Nurse Practitioner | 15272 Summit Ave, Fontana, CA 92336 | 2015-04-03 |
| 1396179115 | Christopher Paul Sanine | Pharmacist | 15272 Summit Ave, Fontana, CA 92336-0231 | 2013-08-28 |
| 1871937425 | Shikha Gupta | Pharmacist | 15272 Summit Ave, Fontana, CA 92336-0231 | 2013-04-25 |
| 1447502174 | Diane Ha | Pharmacist | 15272 Summit Ave, Fontana, CA 92336-0231 | 2012-10-04 |
| 1750639324 | Paula Teresa Olivares | Pharmacist | 15272 Summit Ave, Fontana, CA 92336 | 2012-08-29 |
| 1770832396 | Pasika Lookpla Kleekorn | Pharmacist | 15272 Summit Ave, Fontana, CA 92336-0231 | 2012-08-29 |
| 1144588344 | Aimee Hernandez Maiava | Pharmacist | 15272 Summit Ave, T1958, Fontana, CA 92336-0231 | 2012-04-25 |
| 1376800193 | Jackie Stover | Pharmacist | 15272 Summit Ave, Fontana, CA 92336-0231 | 2012-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700361243 | Schmidt and Jefferson Dental Corporation | Dentist | 16944 South Highland Avenue, Ste. 400, Fontana, CA 92336 | 2018-10-01 |
| 1275032658 | Kenitha Pulliam | Behavioral Analyst | 14051 Catalina Ct, Fontana, CA 92336 | 2018-02-12 |
| 1568961183 | Jordan Frailey | Marriage & Family Therapist | 9161 Sierra Ave. Suite 213, Fontana, CA 92336 | 2018-02-09 |
| 1689198905 | Sara Alyssa Lynch | Specialist/Technologist | 7151 Oak Tree Place, Fontana, CA 92336 | 2017-07-28 |
| 1043749526 | Eric Ceasar Parian Lopez | Registered Nurse | 16001 Pfc Paris Montanez Dr., Fontana, CA 92336 | 2017-06-08 |
| 1275065393 | Alyssa Calderon | Marriage & Family Therapist | 14335 Quail Ct, Fontana, CA 92336 | 2017-03-29 |
| 1588029219 | Daisy Maritza Santana | Behavioral Analyst | 16320 Rosa Linda Ln, Fontana, CA 92336 | 2015-12-23 |
| 1407237498 | Natalie Kathleen Herrera | Physician Assistant | 16456 Sierra Lakes Pkwy, Suite 300, Fontana, CA 92336 | 2015-06-15 |
| 1255738241 | Southern California Picc Providers, Inc. | Spec/Tech, Cardiovascular | 5787 Little Shay Dr, Fontana, CA 92336 | 2014-11-19 |
| 1396175758 | Martha C Ajca | Physician Assistant | 17051 Sierra Lakes Parkway, Suite 101, Fontana, CA 92336 | 2013-11-22 |
| Find all providers in zip 92336 | ||||
| Taxonomy Code | 302R00000X |
| Grouping | Managed Care Organizations |
| Classification | Health Maintenance Organization |
| (1) A form of health insurance in which its members prepay a premium for the HMO’s health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689606196 | Southern California Permanente Medical Group | Health Maintenance Organization | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677760 | Health and Heart | Health Maintenance Organization | 333 W Bastanchury Rd Ste 110, Fullerton, CA 92835-3433 | 2020-10-20 |
| 1144837139 | Essential California Ipa Inc. | Health Maintenance Organization | 1800 Studebaker Rd., 100, Cerritos, CA 90703 | 2020-09-24 |
| 1649881194 | Health Net Community Solutions Inc | Health Maintenance Organization | 21271 Burbank Blvd, Woodland Hills, CA 91367-6667 | 2020-08-10 |
| 1447868377 | Auxilium Health Network, Inc. | Health Maintenance Organization | 18000 Studebaker Dr, Cerritos, CA 90703 | 2020-07-16 |
| 1154939098 | Absolute Medical Partners, A Professional Medical Corporation | Health Maintenance Organization | 18000 Studebaker Rd., Ste 100, Cerritos, CA 90703 | 2020-07-16 |
| 1700494606 | Rapha Ipa, Inc. | Health Maintenance Organization | 1010 Crenshaw Blvd Ste 200, Torrance, CA 90501-2058 | 2020-07-16 |
| 1548883788 | Careplan Ipa, Inc | Health Maintenance Organization | 18000 Studebaker Road, Suite 100, Cerritos, CA 90703-7929 | 2020-05-22 |
| 1982227450 | Zeev Neumeier | Health Maintenance Organization | 1691 Ward St, Berkeley, CA 94703-1827 | 2020-05-19 |
| 1669009247 | Doctor's Managed Ipa, Inc | Health Maintenance Organization | 4959 Palo Verde St Ste 101b, Montclair, CA 91763-2331 | 2020-03-24 |
| 1710512298 | United Physicians Association Inc | Health Maintenance Organization | 14803 Badlona Dr, La Mirada, CA 90638-3834 | 2020-03-05 |
| Find all providers with the same taxonomy | ||||
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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.