TARGET CLINIC MEDICAL ASSOCIATES OF SOUTHERN CALIFORNIA
NPI 1316463763
Health Maintenance Organization in Fontana, CA

Active since August 17, 2017
15272 SUMMIT AVE, FONTANA, CA 92336(877) 608-0044 Get Directions Write a Review

NPPES record last updated: November 2, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 2, 2021, May 27, 2021, Aug 17, 2017 (3 updates tracked since 2017).

About Target Clinic Medical Associates Of Southern California NPPES

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

TARGET CLINIC MEDICAL ASSOCIATES OF SOUTHERN CALIFORNIA (NPI 1316463763) is a healthcare organization registered as a health maintenance organization in Fontana, California and active in the NPI registry since August 2017. The organization lists Ramin Davidoff, Executive Medical Director, as its authorized official.

NPPES Registry Identity

NPI1316463763
Entity TypeOrganization
Primary Taxonomy302R00000X
Legal Business NameSOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
Location Address15272 SUMMIT AVEFontana, CA 92336-0231
Mailing Address393 E Walnut St Fl 3Pasadena, CA 91188-0001 · (877) 608-0044
Organization SubpartNo
Authorized OfficialRamin DavidoffExecutive Medical Director · (877) 608-0044
Enumeration DateAugust 17, 2017
Last NPPES UpdateNovember 2, 20213 updates tracked since enumeration
NPPES CertifiedNovember 2, 2021
✔ NPI 1316463763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHealth Maintenance OrganizationManaged Care Organizations
Taxonomy Code302R00000X
Definition
(1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model.
15272 SUMMIT AVE, Fontana, CA 92336

Other Names 1

Other NameTarget Clinic Medical Associates Of Southern California

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Target Clinic Medical Associates Of Southern California is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5,204

Medicare enrollment records show 5,204 clinicians reassign Medicare billing to Target Clinic Medical Associates Of Southern California, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 888 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 71

Family Practice688
Internal Medicine644
Pediatric Medicine391
Nurse Practitioner334
Marriage and Family Therapist231
Obstetrics/Gynecology205
Diagnostic Radiology200
Emergency Medicine187
63 other specialties2,324

Nearest to this location (20)

See all 5,204
Nurse Practitioner
NPI 1083009286
15272 SUMMIT AVE
Fontana, CA 92336
(909) 463-0513
✔ PECOSSame address
Nurse Practitioner
NPI 1073856068
15218 SUMMIT AVE STE 300-318
Fontana, CA 92336
(909) 952-3043
✔ PECOS✔ Accepts Medicare0.2 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1932525060
15376 ROCHELLE ST
Fontana, CA 92336
(909) 910-4113
✔ Accepts Medicare0.7 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1083091847
4936 SNOWBERRY DR
Fontana, CA 92336
(909) 899-7928
✔ Accepts Medicare0.8 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1548557648
4729 HAWK RIDGE AVE
Fontana, CA 92336
(909) 816-5674
✔ Accepts Medicare1.2 mi
Physical Therapist in Private Practice
NPI 1902563802
16203 CASTELLO LN UNIT 5
Fontana, CA 92336
(917) 794-8778
1.6 mi
Pediatric Medicine
NPI 1376629261
16465 SIERRA LAKES PKWY SUITE 240
Fontana, CA 92336
(909) 355-3100
✔ PECOS1.9 mi
Obstetrics/Gynecology
NPI 1528018488
7430 CHERRY AVE STE 110
Fontana, CA 92336
(909) 350-4620
✔ PECOS2.5 mi
Nurse Practitioner
NPI 1780437202
7426 CHERRY AVE STE 210-632
Fontana, CA 92336
(909) 459-9655
✔ PECOS✔ Accepts Medicare2.5 mi
Family Practice
NPI 1629231147
17051 SIERRA LAKES PKWY SUITE 101
Fontana, CA 92336
(909) 428-2040
✔ PECOS✔ Accepts Medicare2.5 mi
Ophthalmology
NPI 1528321767
7798 CHERRY AVE
Fontana, CA 92336
(909) 445-8535
✔ PECOS✔ Accepts Medicare2.9 mi
Certified Nurse Midwife (CNM)
NPI 1033820469
6584 ELDERBERRY CT
Rancho Cucamonga, CA 91739
(323) 407-1675
✔ PECOS3.5 mi
Emergency Medicine
NPI 1679700017
7615 ETIWANDA AVE UNIT 261
Etiwanda, CA 91739
(917) 524-9909
✔ PECOS✔ Accepts Medicare3.9 mi
Marriage and Family Therapist
NPI 1487326880
17053 FOOTHILL BLVD BLDG 2
Fontana, CA 92335
(909) 347-1356
✔ PECOS✔ Accepts Medicare3.9 mi
Internal Medicine
NPI 1972563765
8110 MANGO AVE
Fontana, CA 92335
(909) 822-1164
✔ PECOS✔ Accepts Medicare4.0 mi
Anesthesiology
NPI 1437343399
12223 HIGHLAND AVE STE 106 UNIT 331
Rancho Cucamonga, CA 91739
(323) 423-4015
✔ PECOS✔ Accepts Medicare4.0 mi
Optometry
NPI 1134560477
8190 MANGO AVE
Fontana, CA 92335
(909) 350-2020
✔ PECOS✔ Accepts Medicare4.0 mi
Clinical Social Worker
NPI 1750668349
3998 OBSIDIAN RD
San Bernardino, CA 92407
(949) 735-8003
✔ PECOS4.2 mi
Hospitalist
NPI 1104915081
9161 SIERRA AVE
Fontana, CA 92335
(909) 427-6110
✔ PECOS✔ Accepts Medicare5.0 mi
Occupational Therapist in Private Practice
NPI 1972726255
9161 SIERRA AVE SUIET 111
Fontana, CA 92335
(909) 427-4073
5.0 mi
See all 5,204 clinicians

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

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 Permanente Medical Group's NPI number?

The NPI number for Southern California Permanente Medical Group is 1316463763. It was assigned to this organization in the NPPES registry on August 17, 2017. The provider is also known as Target Clinic Medical Associates Of Southern California.

Where is Southern California Permanente Medical Group located?

Southern California Permanente Medical Group is located at 15272 Summit Ave, Fontana, CA 92336. The listed phone number is (877) 608-0044.

What is Southern California Permanente Medical Group's specialty?

The primary specialty registered for this NPI is Health Maintenance Organization with taxonomy code 302R00000X.

Is Southern California Permanente Medical Group enrolled in Medicare?

Yes. Southern California Permanente Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southern California Permanente Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 5,204 clinicians in 71 Medicare specialties reassign their Medicare billing to Southern California Permanente Medical Group. 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. The largest specialties are Family Practice (688), Internal Medicine (644) and Pediatric Medicine (391). Of these, 1 practice at this address and 888 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Southern California Permanente Medical Group was last updated on November 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.