| San Gorgonio Memorial Medical Clinic | |
|
264 N Highland Springs Ave Ste 3d Banning CA 92220-3085 | |
| (951) 846-2877 | |
| (951) 846-2876 |
| Full Name | San Gorgonio Memorial Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 264 N Highland Springs Ave Ste 3d, Banning, California |
| Authorized Official Name and Position | Angela Brady (CHIEF NURSING EXECUTIVE/VP) |
| Authorized Official Contact | 5176921859 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Gorgonio Memorial Medical Clinic 264 N Highland Springs Ave Ste 3d Banning CA 92220-3085 Ph: (951) 769-4897 | San Gorgonio Memorial Medical Clinic 264 N Highland Springs Ave Ste 3d Banning CA 92220-3085 Ph: (951) 846-2877 |
| NPI Number | 1194243642 |
|---|---|
| Provider Enumeration Date | 09/05/2017 |
| Last Update Date | 01/26/2026 |
| Certification Date | 01/26/2026 |
| Medicare PECOS PAC ID | 0749556793 |
|---|---|
| Medicare Enrollment ID | O20171019001354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194243642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207V00000X | Obstetrics & Gynecology | () | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Jasleen Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811308109 PECOS PAC ID: 9133437353 Enrollment ID: I20151007001760 |
| Provider Name | Tiana a Davison |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740706670 PECOS PAC ID: 4486912482 Enrollment ID: I20171221000154 |
| Provider Name | Crystal N Pruitt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215357793 PECOS PAC ID: 9830449453 Enrollment ID: I20180831001555 |
| Provider Name | Brandon E Mccullough |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659993624 PECOS PAC ID: 3476964453 Enrollment ID: I20201123002560 |
| Provider Name | Peter Wei |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134707680 PECOS PAC ID: 8022476118 Enrollment ID: I20230622000119 |
| Provider Name | Hrant Gevorgian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619541893 PECOS PAC ID: 1951741909 Enrollment ID: I20240424003465 |
| Provider Name | Carlos Alberto Banuelos Ramirez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346008414 PECOS PAC ID: 9830634195 Enrollment ID: I20240710004136 |
| Provider Name | Tatiana Hoeffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487274825 PECOS PAC ID: 8426599721 Enrollment ID: I20240925004252 |
| Provider Name | David Jauyoung Cherng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528718798 PECOS PAC ID: 0244753606 Enrollment ID: I20250326003838 |
| Provider Name | Brian Lam Quach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073262879 PECOS PAC ID: 6406372010 Enrollment ID: I20250428001410 |
New Millenium Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 W Ramsey St, Banning, CA 92220 Phone: 951-849-1950 Fax: 951-849-0080 |
Banning Chc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 940 E Williams St Ste 102, Banning, CA 92220 Phone: 951-849-6794 Fax: 951-849-0060 |
First Americans Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12359 Malki Rd, Banning, CA 92220 Phone: 951-922-2058 Fax: 888-551-2116 |
Harbor Wound Care P.C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1424 Hummingbird Way, Banning, CA 92220 Phone: 626-250-4912 |
Morongo Indian Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11555 1/2 Potrero Rd, Banning, CA 92220 Phone: 951-849-4761 Fax: 951-849-5612 |
Beaver Medical Group, LP Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5957 W Ramsey St, Banning, CA 92220 Phone: 951-845-0313 Fax: 909-796-4158 |