SARATH C WITANA MEDICAL GROUP INC (NPI# 1568573160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568573160 |
| Entity Type | Organization |
| Organization Name | SARATH C WITANA MEDICAL GROUP INC |
| Practice Address |
24060 Fir Ave Suite A Moreno Valley CA 92553-2895 |
| Practice Telephone | 9512436460 |
| Practice Fax Number | 9512435871 |
| Mailing Telephone | 9512436460 |
| Mailing Fax Number | 9512435871 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2011-03-08 |
| Authorized Official Name | DR. SARATH C WITANA (MEDICAL DOCTOR) |
| Authorized Official Telephone | 9512436460 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | A50338 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A503380 | 05 |
| Street Address |
24060 FIR AVE SUITE A |
| City | MORENO VALLEY |
| State | CA |
| Zip Code | 92553-2895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518950377 | Sudhakar Dixit | Obstetrics & Gynecology | 24060 Fir Ave, Moreno Valley, CA 92553-2841 | 2005-08-26 |
| 1801960646 | Sarath C Witana | Internal Medicine | 24060 Fir Ave, Suite A, Moreno Valley, CA 92553-2895 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104441559 | Tanya Gentle | Marriage & Family Therapist | 2319 Cottonwood Avenue, Building A Suite 110, Moreno Valley, CA 92553 | 2020-06-11 |
| 1275194227 | Antonio Pearce | Psychologist | 12968 Frederick Street, Suite D, Moreno Valley, CA 92553 | 2019-06-20 |
| 1346726486 | Elias Y. Rached | Chiropractor | 23846 Sunnymead Blvd Ste 4, Moreno Valley, CA 92553 | 2018-07-12 |
| 1952813420 | Shanaya Frederick | Driver | 14929 Spinnaker Lane, Moreno Valley, CA 92553 | 2017-10-24 |
| 1457879413 | R & C Logistic Services, LLC | Private Vehicle | 14768 Briana St, Moreno Valley, CA 92553 | 2017-08-30 |
| 1720505084 | Elda Pricila Hernandez | Behavioral Analyst | 24596 Atwood Ave.apt1, Moreno Valley, CA 92553 | 2017-08-28 |
| 1174044101 | Ps Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 24594 Sunnymead Blvd, Suite M, Moreno Valley, CA 92553 | 2017-06-29 |
| 1942736327 | Richard Pantoja Reyna | Licensed Vocational Nurse | 23119 Cottonwood Ave Bld A Suite 110, Moreno Valley, CA 92553 | 2017-05-04 |
| 1255872719 | Sibonisiwe Moyo Johnson | Nurse Practitioner | 22555 Alessandro Blvd Ste B, Moreno Valley, CA 92553 | 2017-03-16 |
| 1518311190 | Ryan Macavinta | Nurse Practitioner | 22765 Alessandro Blvd., Moreno Valley, CA 92553 | 2016-04-20 |
| Find all providers in zip 92553 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255692349 | Rowena Kai Ling Mak-huang | Internal Medicine | 11441 Heacock St Ste C, Moreno Valley, CA 92557-7907 | 2012-06-05 |
| 1477799344 | Shelly Xiaolei Xing Gammon | Internal Medicine | 27200 Iris Ave, Moreno Valley, CA 92555 | 2008-12-26 |
| 1669631016 | Sharareh Movafagh-tofigh | Internal Medicine | 12712 Heacock St Ste 1, Moreno Valley, CA 92553-3037 | 2008-06-02 |
| 1104022078 | Jose Limon Professional Medical Coorporation | Internal Medicine | 22635 Alessandro Blvd., Unit 400, Suite A, Moreno Valley, CA 92553-2854 | 2007-06-26 |
| 1659584019 | Srilakshmi Vemulakonda | Internal Medicine | 17771 Camino Del Rey, Moreno Valley, CA 92551-6354 | 2007-05-08 |
| 1083790513 | Gamal F Ghaly | Internal Medicine | 14114 Business Center Dr. Ste. G, Moreno Valley, CA 92553-9113 | 2006-10-27 |
| 1720018237 | Joel A Pengson | Internal Medicine | 23180 Hemlock Ave Ste 201, Moreno Valley, CA 92557-8001 | 2006-07-03 |
| 1366438574 | Johnny A Liquete | Internal Medicine | 14114 Business Center Dr, Suite D, Moreno Valley, CA 92553-9113 | 2005-09-22 |
| 1437141660 | Cuong Robert Nguyen | Internal Medicine | 24853 Alessandro Blvd Ste 4, Moreno Valley, CA 92553-6102 | 2005-08-15 |
| 1346886140 | Joshua Pengson, M.d. Inc. | Internal Medicine | 23180 Hemlock Ave Ste 201, Moreno Valley, CA 92557-8001 | 2019-11-27 |
| Find all providers in MORENO VALLEY | ||||
| City | MORENO VALLEY |
| Zip Code | 92553 |
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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.