PACIFIC CARE MEDICAL GROUP, INC. (NPI# 1114126380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114126380 |
| Entity Type | Organization |
| Organization Name | PACIFIC CARE MEDICAL GROUP, INC. |
| Practice Address |
81840 Avenue 46 Suite 103 Indio CA 92201-3936 |
| Mailing Address |
6800 Lincoln Ave Suite 200 Buena Park CA 90620-4162 |
| Practice Telephone | 7603472602 |
| Mailing Telephone | 7149955400 |
| Mailing Fax Number | 7149955254 |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2007-07-17 |
| Authorized Official Name | SIM C. HOFFMAN (PRESIENT) |
| Authorized Official Telephone | 7149955400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 204D00000X | Neuromusculoskeletal Medicine & OMM | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207X00000X | Orthopaedic Surgery | G15295 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669671830 | Pacific Care Medical Group, Inc. | Psychologist | 559 N Central Ave, Upland, CA 91786-4241 | 2007-07-17 |
| 1679772842 | Pacific Care Medical Group, Inc. | Psychologist | 6800 Lincoln Ave, Suite 202, Buena Park, CA 90620-4162 | 2007-07-17 |
| Street Address |
81840 AVENUE 46 SUITE 103 |
| City | INDIO |
| State | CA |
| Zip Code | 92201-3936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508063801 | Ernesto C Abadilla Jr. | Dentist | 81840 Avenue 46, Ste 105, Indio, CA 92201-3936 | 2007-06-29 |
| 1831454008 | Bruce Alan Sherr | Case Manager/Care Coordinator | 81840 Avenue 46, Suite 201, Indio, CA 92201-3936 | 2012-07-12 |
| 1528322864 | Esther Kim | Case Manager/Care Coordinator | 81840 Avenue 46, Suite 201, Indio, CA 92201-3936 | 2012-07-02 |
| 1467745158 | David Christopher Johnson | Case Manager/Care Coordinator | 81840 Avenue 46, Ste. 201, Indio, CA 92201-3936 | 2011-05-27 |
| 1285931535 | Hyun Ju Park | Case Manager/Care Coordinator | 81840 Avenue 46, Suite 201, Indio, CA 92201-3936 | 2011-02-23 |
| 1568768885 | Keisuke Kubota | Case Manager/Care Coordinator | 81840 Avenue 46, Indio, CA 92201-3936 | 2011-02-03 |
| 1164732145 | Margaret Marcos Houston | Case Manager/Care Coordinator | 81840 Avenue 46, Suite 201, Indio, CA 92201-3936 | 2010-10-08 |
| 1225345952 | Ayanna Kaia Scott-hernandez | Counselor | 81840 Avenue 46, Suite 201, Indio, CA 92201-3936 | 2010-09-01 |
| 1013168970 | Kevin G Brown Sr. | Counselor | 81840 Avenue 46, 201, Indio, CA 92201-3936 | 2008-10-08 |
| 1700049723 | Frances P. Jacobs | Counselor | 81840 Avenue 46, #201, Indio, CA 92201-3936 | 2008-07-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174151534 | Kayla Marie Berry | Licensed Vocational Nurse | Telecare Riverside County Psychiatric Health Facility, Indio, CA 92201 | 2020-03-31 |
| 1699327353 | Nawar Hadid | Dentist | 81735 Ca-111, Indio, CA 92201 | 2019-07-12 |
| 1427521889 | Thanh Trang Thi Nguyen Md Inc | Internal Medicine | 44100 Jefferson St., #e507, Indio, CA 92201 | 2019-01-09 |
| 1306328315 | Grant Nishimura | Dentist | 81-637, Suite 1, Ca-111, Indio, CA 92201 | 2018-09-06 |
| 1700363645 | Desert Physical Medicine | General Practice | 81765 Highway 111, Ste #3, Indio, CA 92201 | 2018-07-24 |
| 1336668151 | U & I Care Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 44105 Jackson St Ste 204, Indio, CA 92201 | 2017-09-13 |
| 1154847234 | Myung Kee Park | Dentist | 81106 Ca-111, #c, Indio, CA 92201 | 2017-08-21 |
| 1912434937 | Mirage Home Health | Home Health | 82691 Miles Ave, Indio, CA 92201 | 2017-05-22 |
| 1497294821 | Orthopedic and Physical Medicine Associates Inc | Chiropractor | 81765 Hwy 111, #3, Indio, CA 92201 | 2017-02-17 |
| 1497103758 | Timothy Smith | Contractor | 81337 Avenida Romero, Indio, CA 92201 | 2016-05-27 |
| Find all providers in zip 92201 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487873006 | George G Glancz | Orthopaedic Surgery | 81833 Doctor Carreon Blvd, Suite 5, Indio, CA 92201-5590 | 2007-04-24 |
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| 1194343855 | Orthopaedic Group of Orange County | Orthopaedic Surgery | 1200 N Tustin Ave Ste 250, Santa Ana, CA 92705-3596 | 2020-07-09 |
| 1497372536 | Kaley Brown Surgical Pa | Orthopaedic Surgery | 360 Tom Mcguinness Jr Cir, Fallbrook, CA 92028-2623 | 2020-07-05 |
| 1982220612 | Advanced Orthopaedic Surgeons At Long Beach, Inc | Orthopaedic Surgery | 1760 Termino Ave Ste 208, Long Beach, CA 90804-2151 | 2020-06-18 |
| 1982227609 | Sun Medical Group Huntington, Inc | Orthopaedic Surgery | 7801 Center Ave Ste 203, Huntington Beach, CA 92647-9118 | 2020-05-28 |
| 1932722733 | Julian Hakim Baloyan | Orthopaedic Surgery | 333 H St Ste 5000503, Chula Vista, CA 91910-5555 | 2020-05-27 |
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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.