LA SIERRA MEDICAL CORP
NPI 1164527271
Exclusive Provider Organization in Riverside, CA

Active since September 13, 2006CLIA 05D0994516 · Waiver
4712B LA SIERRA AVE, RIVERSIDE, CA 92505(951) 324-8100(951) 324-8103 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About La Sierra Medical Corp NPPES

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

LA SIERRA MEDICAL CORP (NPI 1164527271) is a healthcare organization registered as an exclusive provider organization in Riverside, California and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through December 23, 2027 and lists Chidozie Constance Mbagwu, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1164527271
Entity TypeOrganization
Primary Taxonomy302F00000X
Legal Business NameLA SIERRA MEDICAL CORP
Location Address4712B LA SIERRA AVERiverside, CA 92505-2726
Mailing Address4712b La Sierra AveRiverside, CA 92505-2726 · (951) 324-8100 · Fax (951) 324-8103
Fax(951) 324-8103
Organization SubpartNo
Authorized OfficialChidozie Constance MbagwuMedical Director · (951) 324-8100
Enumeration DateSeptember 13, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1164527271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyExclusive Provider OrganizationManaged Care Organizations
Taxonomy Code302F00000X
License✔ Licensed in CA · A513990
Definition
(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.
4712B LA SIERRA AVE, Riverside, CA 92505

Other Identifiers 1

MedicaidGR0100940CA

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 05D0994516

La Sierra Medical Clinic · Riverside, CA
Active · expires Dec 23, 2027
CLIA Number05D0994516
Laboratory TypePhysician Office
Certificate Effective DateDecember 24, 2025
Certificate Expiration DateDecember 23, 2027
Laboratory DirectorChidozie Mbagwu
Laboratory Phone(951) 324-8100
Laboratory LocationLa Sierra Medical Clinic10600 Magnolia Ave Ste I, Riverside, CA 92505
CLIA data matches this NPI record on: 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 La Sierra Medical Corp's NPI number?

The NPI number for La Sierra Medical Corp is 1164527271. It was assigned to this organization in the NPPES registry on September 13, 2006.

Where is La Sierra Medical Corp located?

La Sierra Medical Corp is located at 4712B La Sierra Ave, Riverside, CA 92505. The listed phone number is (951) 324-8100.

What is La Sierra Medical Corp's specialty?

The primary specialty registered for this NPI is Exclusive Provider Organization with taxonomy code 302F00000X.

Does La Sierra Medical Corp hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0994516) is associated with this NPI, valid through December 23, 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 La Sierra Medical Corp was last updated on August 22, 2020. 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.