SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP (NPI# 1336556059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336556059 |
| Entity Type | Organization |
| Organization Name | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| Other Organization Name | TARGET CLINIC MEDICAL ASSOCIATES OF SOUTHERN CALIFORNIA |
| Practice Address |
1893 W Malvern Ave Fullerton CA 92833-2403 |
| Mailing Address |
393 E Walnut St Provider Enrollment, 3rd Floor Pasadena CA 91188-0001 |
| Practice Telephone | 8776080044 |
| Mailing Telephone | 8776080044 |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2014-10-21 |
| Authorized Official Name | DR. EDWARD M ELLISON JR. (EXECUTIVE MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8776080044 |
| Authorized Official Credential | M.D. |
| 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 | Doing Business As Name - 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 |
1893 W MALVERN AVE |
| City | FULLERTON |
| State | CA |
| Zip Code | 92833-2403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629090311 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1893 W Malvern Ave, Fullerton, CA 92833-2403 | 2006-07-24 |
| 1396122156 | Florence Kim | Nurse Practitioner | 1893 W Malvern Ave, Fullerton, CA 92833 | 2015-04-30 |
| 1316206550 | Mai Tang Od, Inc | Optometrist | 1893 W Malvern Ave, Fullerton, CA 92833-2403 | 2012-05-09 |
| 1356628044 | Michael E Jung | Pharmacist | 1893 W Malvern Ave, Fullerton, CA 92833-2403 | 2011-11-08 |
| 1841587524 | Amir Kativ | Pharmacist | 1893 W Malvern Ave, Target Pharmacy Store Number T-1383, Fullerton, CA 92833-2403 | 2011-07-01 |
| 1891080412 | Lisa Yichu Chiang | Pharmacist | 1893 W Malvern Ave, T-1383, Fullerton, CA 92833-2403 | 2011-06-10 |
| 1962530709 | Tricia S. Kawaguchi | Optometrist | 1893 W Malvern Ave, Fullerton, CA 92833-2403 | 2007-03-02 |
| 1144365396 | Mai Tang | Optometrist | 1893 W Malvern Ave, Fullerton, CA 92833-2403 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790333565 | Qz Enterpprises Corp | In Home Supportive Care | 2817 Muir Trail Dr, Fullerton, CA 92833 | 2019-08-26 |
| 1780114306 | Acupuncture Nara Inc | Clinic/Center | 2334 W. Valencia Dr., Fullerton, CA 92833 | 2017-06-15 |
| 1518350149 | Young A Lee | Nurse Practitioner | 2529 Monterey Pl, Fullerton, CA 92833 | 2015-03-06 |
| 1538557871 | Annacess Arcadio | Occupational Therapy Assistant | 1437 W Woodcrest Ave, Fullerton, CA 92833 | 2015-01-08 |
| 1710306923 | Nora Edith Heredia | Counselor | 1060 S Brookhurst Road, Fullerton, CA 92833 | 2014-04-15 |
| 1912322892 | Louis Michael Hinzo | Counselor | 1060 S. Brookhurst Rd., Fullerton, CA 92833 | 2014-02-28 |
| 1497011290 | Paul Choong Hwan Lee, M.d. A Medical Corporation | Ophthalmology | 1401 S. Brookhurst Rd., Suite 107, Fullerton, CA 92833 | 2012-04-05 |
| 1992073860 | Tammy Phan | Pharmacist | 1826 W Orangethrope Ave, Fullerton, CA 92833 | 2011-12-07 |
| 1346577160 | Hara Orthotics and Prosthetics,inc | Prosthetic/Orthotic Supplier | 1343 W. Valencia Dr., Suite E, Fullerton, CA 92833 | 2009-11-16 |
| 1265669923 | Marcelle Bonneau Taylor | Marriage & Family Therapist | 1145 W. Valencia Mesa, Emmanuel Episcopal Church, Fullerton, CA 92833 | 2009-06-19 |
| Find all providers in zip 92833 | ||||
| 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 |
|---|---|---|---|---|
| 1629677760 | Health and Heart | Health Maintenance Organization | 333 W Bastanchury Rd Ste 110, Fullerton, CA 92835-3433 | 2020-10-20 |
| 1720385313 | Monarch Medical Mangement, Inc. | Health Maintenance Organization | 3711 N Harbor Blvd Ste C, Fullerton, CA 92835-1362 | 2011-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1356974828 | Capital Health Physicians Inc | Health Maintenance Organization | 1010 N Central Ave Ste 208, Glendale, CA 91202-2937 | 2020-02-12 |
| 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.