SOUTHERN CALIFORNIA PRIMARY MEDICAL INC
NPI 1043508559
Family Medicine - Geriatric Medicine in Apple Valley, CA

Q: What is Southern California Primary Medical Inc's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Active since July 18, 2011CLIA Certified · 2 labs

19341 BEAR VALLEY RD STE 101, APPLE VALLEY, CA 92308(760) 810-7778(760) 810-7780 Get Directions Write a Review

NPPES record last updated: August 6, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Southern California Primary Medical Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN CALIFORNIA PRIMARY MEDICAL INC (NPI 1043508559) is a healthcare organization registered as a geriatric medicine in Apple Valley, California and active in the NPI registry since July 2011. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Rancho Cucamonga, and lists Ashish Malhotra, Owner, as its authorized official.

NPPES Registry Identity

NPI1043508559

Entity TypeOrganization

Primary Taxonomy207QG0300X

Legal Business NameSOUTHERN CALIFORNIA PRIMARY MEDICAL INC

Location Address19341 BEAR VALLEY RD STE 101Apple Valley, CA 92308

Mailing Address8237 Rochester Ave Ste 110Rancho Cucamonga, CA 91730-0717 · (909) 477-3310 · Fax (909) 477-3320

Phone(760) 810-7778

Fax(760) 810-7780

Organization SubpartNo

Authorized OfficialAshish MalhotraOwner · (760) 810-7778

Enumeration DateJuly 18, 2011

Last NPPES UpdateAugust 6, 2018

✔ NPI 1043508559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QG0300X

License✔ Licensed in CA · A91216

Definition

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X · License A91216 (CA)

19341 BEAR VALLEY RD STE 101, Apple Valley, CA 92308

Open in Google Maps ↗

Secondary Practice Location 1

Location 18237 Rochester Ave Ste 110Rancho Cucamonga, CA 91730-0717 · Phone (909) 477-3310 · Fax (909) 477-3320

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southern California Primary Medical Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Southern California Primary Medical Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ashish Malhotra, M.D.

Family Practice

NPI 1679583744

19341 BEAR VALLEY RD SUITE 101
Apple Valley, CA 92308

(760) 810-7778

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2030474

Southern California Primary Medical Inc · Apple Valley, CA

Active · expires Apr 2, 2027

CLIA Number05D2030474

Laboratory TypePhysician Office

Certificate Effective DateApril 3, 2025

Certificate Expiration DateApril 2, 2027

Laboratory DirectorAshish Malhotra MD

Laboratory Phone(760) 810-7778

Laboratory LocationSouthern California Primary Medical Inc19341 Bear Valley Rd Ste 101, Apple Valley, CA 92308

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2052175

Southern California Primary Medical, Inc · Rancho Cucamonga, CA

Active · expires Jan 6, 2027

CLIA Number05D2052175

Laboratory TypePhysician Office

Certificate Effective DateJanuary 7, 2025

Certificate Expiration DateJanuary 6, 2027

Laboratory DirectorAshish Malhotra

Laboratory Phone(909) 477-3310

Laboratory LocationSouthern California Primary Medical, Inc8237 Rochester Ave Ste 110, Rancho Cucamonga, CA 91730

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern California Primary Medical Inc's NPI number?

The NPI number for Southern California Primary Medical Inc is 1043508559. It was assigned to this organization in the NPPES registry on July 18, 2011.

Where is Southern California Primary Medical Inc located?

Southern California Primary Medical Inc is located at 19341 Bear Valley Rd Ste 101, Apple Valley, CA 92308. The listed phone number is (760) 810-7778.

What is Southern California Primary Medical Inc's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Is Southern California Primary Medical Inc enrolled in Medicare?

Yes. Southern California Primary Medical Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southern California Primary Medical Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Southern California Primary Medical Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Southern California Primary Medical Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Southern California Primary Medical Inc was last updated on August 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.