JARCO MEDICAL GROUP, LLC (NPI# 1770725939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770725939 |
| Entity Type | Organization |
| Organization Name | JARCO MEDICAL GROUP, LLC |
| Practice Address |
12030 La Cadena Dr Grand Terrace CA 92313-3613 |
| Mailing Address |
Po Box M Loma Linda CA 92354-0556 |
| Practice Telephone | 9092224779 |
| Practice Fax Number | 9092224779 |
| Mailing Telephone | 9092224779 |
| Mailing Fax Number | 9092224779 |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2010-05-19 |
| Authorized Official Name | MR. JECONIAS LOPEZ DEMIAR (MANAGER) |
| Authorized Official Telephone | 9092224779 |
| Authorized Official Credential | CRNA, RN, NA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
RN160039 | CA | Ambulatory Health Care Facilities |
| Street Address |
12030 LA CADENA DR |
| City | GRAND TERRACE |
| State | CA |
| Zip Code | 92313-3613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427321322 | Noelle Angelica Leon | Technician, Pathology | 22799 Desoto Street, Grand Terrace, CA 92313 | 2012-02-23 |
| 1487885497 | Impression Healthcare Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 22573 Barton Rd., Grand Terrace, CA 92313 | 2009-08-07 |
| 1528230869 | Patricia Zappia | Specialist | 22927 Grand Terrace Road, Grand Terrace, CA 92313 | 2008-03-27 |
| 1558579755 | Robert Mitchell Norman | Psychiatry & Neurology | Riverside San Bernardino Indian Health, Inc., 11980 Mt Vernon Ave, Grand Terrace, CA 92313 | 2007-05-19 |
| 1477752913 | Joseph Allan Pruitt | Optometrist | 11980 Mount Vernon Ave, Grand Terrace, CA 92313 | 2007-07-14 |
| 1376015164 | Trescina Michelle Hernandez | Assistant Behavior Analyst | 22887 Brentwood St, Grand Terrace, CA 92313-4908 | 2018-12-18 |
| 1811037492 | Jonbec Care Inc. | Intermediate Care Facility, Mentally Retarded | 11868 Canal St, Grand Terrace, CA 92313-4941 | 2007-02-06 |
| 1922028406 | Heather Carriedo | Pediatrics | 23251 Glendora Dr, Grand Terrace, CA 92313-4965 | 2006-07-20 |
| 1760683866 | Emeritus Corporation | Alzheimer Center (Dementia Center) | 22325 Barton Rd, Grand Terrace, CA 92313-5006 | 2007-05-29 |
| 1780985747 | Jerome Mendiola Ocampo | Dentist | 22421 Barton Rd # 291, Grand Terrace, CA 92313-5008 | 2010-11-08 |
| Find all providers in zip 92313 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851671531 | Charms Property Incorporated | Clinic/Center | 22809 Barton Rd, Grand Terrace, CA 92313-5208 | 2011-08-25 |
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| 1366041469 | The Regents of The University of California | Clinic/Center | 4343 Lankershim Blvd Ste 210, North Hollywood, CA 91602-2705 | 2020-10-20 |
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1396352944 | Irvine Surgical Center LLC | Clinic/Center | 17624 Redhill Ave Ste B, Irvine, CA 92614 | 2020-09-28 |
| 1538775267 | Ev Surgery Institute LLC | Clinic/Center | 105 N Bascom Ave Ste 105, San Jose, CA 95128-1811 | 2020-09-18 |
| 1003420001 | On Beach Surgery Center, LLC | Clinic/Center | 5832 Beach Blvd, Suite 210, Buena Park, CA 90621 | 2020-09-07 |
| 1811501661 | Precision Surgical Arts | Clinic/Center | 20311 Sw Birch St Ste 201, Newport Beach, CA 92660-1777 | 2020-08-31 |
| 1205448750 | Elite Surgery Center of South Bay LLC | Clinic/Center | 20528 Hawthorne Blvd Ste 301, Torrance, CA 90503-3202 | 2020-08-17 |
| 1740891571 | Peninsula Surgery Center, LLC | Clinic/Center | 350 Marine Pkwy Ste 100, Redwood City, CA 94065-5224 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
| City | GRAND TERRACE |
| Zip Code | 92313 |
Please comment or provide details below to improve the information on JARCO MEDICAL GROUP, LLC.
| 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.