SAN MARCOS MEDICAL GROUP INC. (NPI# 1235189978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235189978 |
| Entity Type | Organization |
| Organization Name | SAN MARCOS MEDICAL GROUP INC. |
| Other Organization Name | METROPOLITAN FAMILY MEDICAL CLINIC |
| Practice Address |
742 W Highland Ave San Bernardino CA 92405-3839 |
| Practice Telephone | 9098817320 |
| Practice Fax Number | 9098817330 |
| Mailing Telephone | 9098817320 |
| Mailing Fax Number | 9098817330 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2012-02-29 |
| Authorized Official Name | NATT BALBIR (MD/PRESIDENT) |
| Authorized Official Telephone | 9517515470 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | GR0086724 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A764460 | 05 | |
| CA | 00A460220 | 05 | |
| CA | GR0086724 | 05 | |
| CA | 00AX91490 | 05 | |
| CA | 00A514170 | 05 | |
| CA | 00A398050 | 05 | |
| CA | 00A450910 | 05 | |
| CA | 00A529660 | 05 |
| Other Name | Type Code |
|---|---|
| METROPOLITAN FAMILY MEDICAL CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548210297 | San Marcos Medical Group Inc. | Family Medicine | 7576 Sterling Ave, San Bernardino, CA 92410-4202 | 2006-05-11 |
| 1447396593 | San Marcos Medical Group Inc. | Clinical Medical Laboratory | 1574 W Base Line St Ste 107, San Bernardino, CA 92411-1736 | 2007-01-29 |
| 1952351686 | San Marcos Medical Group Inc. | Family Medicine | 4990 Arlington Ave, Riverside, CA 92504-2757 | 2006-05-11 |
| 1639129372 | San Marcos Medical Group Inc. | Family Medicine | 7965 Sierra Ave, Fontana, CA 92336-3329 | 2006-05-11 |
| 1184674830 | San Marcos Medical Group Inc. | Family Medicine | 1574 W Base Line St, San Bernardino, CA 92411-1736 | 2006-05-11 |
| Street Address |
742 W HIGHLAND AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92405-3839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093789000 | Elaine Marie Gackle | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2006-02-15 |
| 1336789890 | Borrego Community Health Foundation | Clinic/Center | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2020-01-13 |
| 1841844990 | Karl Amparo | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2019-07-27 |
| 1760975825 | Ambika Ranabhat | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2018-06-12 |
| 1770074791 | Nomagugu Mafu | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2018-05-24 |
| 1083008254 | Maretha Tyce | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2015-03-25 |
| 1366831653 | Yoggie Efendy | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2015-01-09 |
| 1215216965 | Oluwamuyiwa Bolonduro | Obstetrics & Gynecology | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2011-08-12 |
| 1487932372 | Hobart Leung | Internal Medicine | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2011-07-27 |
| 1265744718 | Ray Lengvilas | Pediatrics | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2010-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174177497 | New Hope Transitional Living | Clinical Nurse Specialist | 1228 West 31st, San Bernardino, CA 92405 | 2019-07-25 |
| 1336647494 | Paul J Iorio | Counselor | 1669 Norht E Street, San Bernardino, CA 92405 | 2018-01-24 |
| 1609385756 | Abraham Isacc Gonzalez | Registered Nurse | 255 W 17th St, San Bernardino, CA 92405 | 2017-09-20 |
| 1962945675 | Ann Marie Monica Clark | Assisted Living Facility | 3524 Acacia Avenue, San Bernardino, CA 92405 | 2016-11-29 |
| 1801265715 | Leslie Del Toro | Counselor | 2025 N D St, San Bernardino, CA 92405 | 2015-09-21 |
| 1558797324 | Nora Escobar-mandujano | Marriage & Family Therapist | 1441 North 'd' Street, San Bernardino, CA 92405 | 2013-09-24 |
| 1295088284 | Elizabeth Rocha | Counselor | 1669 North E Street, San Bernardino, CA 92405 | 2012-10-16 |
| 1972855237 | Vanessa Kelly Gutierrez | Marriage & Family Therapist | 1669 N E Street, San Bernardino, CA 92405 | 2012-10-11 |
| 1952664021 | Mosley Counseling Center, LLC | Counselor | 2130 W. Arrowhead Ave., Suite 103c, San Bernardino, CA 92405 | 2012-06-22 |
| 1508167602 | Al Shifa Clinic Incorporated | Voluntary or Charitable | 2334 North Sierra Way, San Bernardino, CA 92405 | 2010-11-06 |
| Find all providers in zip 92405 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346803954 | Community Health Care Foundation | Family Medicine | 406 E Vanderbilt Way Bldg 8, San Bernardino, CA 92408-3552 | 2019-04-18 |
| 1558837153 | Inland Empire Health Centers | Family Medicine | 1374 N Waterman Ave, San Bernardino, CA 92404-5313 | 2018-10-22 |
| 1356846281 | Maria Socorro Ruiz-rodriguez | Family Medicine | 850 W Highland Ave Ste A, San Bernardino, CA 92405-3855 | 2018-03-23 |
| 1588041859 | Mai-linh Ngoc Tran | Family Medicine | 1455 3rd Ave, San Bernardino, CA 92408 | 2015-05-06 |
| 1932514239 | Sarah Kin | Family Medicine | 1499 E Highland Ave, San Bernardino, CA 92404-4611 | 2014-06-25 |
| 1689930570 | Healthy Baby & Me, A Medical Corporation | Family Medicine | 1666 Medical Center Dr Ste 3, San Bernardino, CA 92411-1257 | 2012-04-05 |
| 1649548462 | Ralph R. Vega M.d., Dabfp Inc | Family Medicine | 1666 N. Medical Center Dr, Suite 2, San Bernardino, CA 92411-1257 | 2011-12-07 |
| 1477860187 | Molina Healthcare of California | Family Medicine | 170 East Highland Ave, San Bernardino, CA 92404-3658 | 2010-09-02 |
| 1043441900 | Healthy Preferred Inc | Family Medicine | 475 S Arrowhead Ave, Ste D, San Bernardino, CA 92408-1347 | 2009-07-27 |
| 1568629889 | Tae Kyu Kim | Family Medicine | 275 W Hospitality Ln Ste 200, San Bernardino, CA 92408-3238 | 2008-05-22 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92405 |
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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.