| Orangecrest Medical Group, Inc. | |
|
4646 Brockton Ave Ste 203 Riverside CA 92506-0104 | |
| (951) 774-2881 | |
| (951) 774-2846 |
| Full Name | Orangecrest Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 4646 Brockton Ave Ste 203, Riverside, California |
| Authorized Official Name and Position | Yolanda Sanchez (OPERATIONS MANAGER) |
| Authorized Official Contact | 9516821622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orangecrest Medical Group, Inc. 4646 Brockton Ave Ste 203 Riverside CA 92506-0104 Ph: (951) 774-2881 | Orangecrest Medical Group, Inc. 4646 Brockton Ave Ste 203 Riverside CA 92506-0104 Ph: (951) 774-2881 |
| NPI Number | 1033676317 |
|---|---|
| Provider Enumeration Date | 02/22/2019 |
| Last Update Date | 10/13/2023 |
| Medicare PECOS PAC ID | 1456747369 |
|---|---|
| Medicare Enrollment ID | O20220401000379 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033676317 | NPI | - | NPPES |
| 4232015 | Other | CA | ARTICLES OF INCORPORATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Raj K Sindher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477540615 PECOS PAC ID: 9436059110 Enrollment ID: I20070614000672 |
| Provider Name | John D Branch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174510309 PECOS PAC ID: 1052211737 Enrollment ID: I20070710000572 |
| Provider Name | Harold W Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235126475 PECOS PAC ID: 7517867294 Enrollment ID: I20090408000442 |
| Provider Name | Mary Elizabeth Barba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447659370 PECOS PAC ID: 4688061575 Enrollment ID: I20220422002271 |
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