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CAJON MEDICAL GROUP PC
NPI 1073169298
Internal Medicine in Chino, CA

Active since August 13, 2019CLIA 05D2172757 · Waiver
12555 CENTRAL AVE STE A, CHINO, CA 91710(909) 735-2446(909) 206-1553 Get Directions Write a Review

NPPES record last updated: August 13, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cajon Medical Group Pc NPPES

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

CAJON MEDICAL GROUP PC (NPI 1073169298) is a healthcare organization registered as an internal medicine in Chino, California and active in the NPI registry since August 2019. The organization holds a CLIA Waiver certificate valid through September 29, 2027 and lists Syam P Kunam, Ceo, as its authorized official.

NPPES Registry Identity

NPI1073169298
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCAJON MEDICAL GROUP PC
Location Address12555 CENTRAL AVE STE AChino, CA 91710-3569
Mailing Address1809 W Redlands BlvdRedlands, CA 92373-8054 · (909) 735-2446 · Fax (909) 206-1553
Phone(909) 735-2446
Fax(909) 206-1553
Organization SubpartNo
Authorized OfficialSyam P KunamCeo · (909) 735-2446
Enumeration DateAugust 13, 2019
✔ NPI 1073169298 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
12555 CENTRAL AVE STE A, Chino, CA 91710
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Other Names 1

Doing Business AsCajon Medical Group Pc

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 05D2172757

Cajon Medical Group PC · Redlands, CA
Active · expires Sep 29, 2027
CLIA Number05D2172757
Laboratory TypePhysician Office
Certificate Effective DateSeptember 30, 2025
Certificate Expiration DateSeptember 29, 2027
Laboratory DirectorArchis D. Desai
Laboratory Phone(909) 735-2446
Laboratory LocationCajon Medical Group PC1809 W Redlands Boulevard, Redlands, CA 92373
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 Cajon Medical Group PC's NPI number?

The NPI number for Cajon Medical Group PC is 1073169298. It was assigned to this organization in the NPPES registry on August 13, 2019.

Where is Cajon Medical Group PC located?

Cajon Medical Group PC is located at 12555 Central Ave Ste A, Chino, CA 91710. The listed phone number is (909) 735-2446.

What is Cajon Medical Group PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Cajon Medical Group PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2172757) is associated with this NPI, valid through September 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cajon Medical Group PC was last updated on August 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.