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SOUTHERN CALIFORNIA PRIMARY CARE MEDICAL GROUP, INC
NPI 1376632281
Family Medicine in Lake Elsinore, CA

Active since October 11, 2006CLIA 05D0574214 · Waiver
31581 CANYON ESTATES DR, LAKE ELSINORE, CA 92532(951) 244-3500(951) 244-3535 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 2, 2025, May 14, 2025 (2 updates tracked since 2025).

About Southern California Primary Care Medical Group, Inc NPPES

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

SOUTHERN CALIFORNIA PRIMARY CARE MEDICAL GROUP, INC (NPI 1376632281), doing business as Canyon Lake Urgent & Family Care, is a healthcare organization registered as a family medicine in Lake Elsinore, California and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Mohammad R Danesh, Director, as its authorized official.

NPPES Registry Identity

NPI1376632281
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTHERN CALIFORNIA PRIMARY CARE MEDICAL GROUP, INC
Location Address31581 CANYON ESTATES DRLake Elsinore, CA 92532-0424
Mailing Address31581 Canyon Estates DrLake Elsinore, CA 92532-0424 · (951) 244-3500 · Fax (951) 244-3535
Phone(951) 244-3500
Fax(951) 244-3535
Organization SubpartNo
Authorized OfficialMohammad R DaneshDirector · (951) 244-3500
Enumeration DateOctober 11, 2006
Last NPPES UpdateSeptember 2, 20252 updates tracked since enumeration
NPPES CertifiedMay 14, 2025
✔ NPI 1376632281 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
31581 CANYON ESTATES DR, Lake Elsinore, CA 92532
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Other Names 1

Doing Business AsCanyon Lake Urgent & Family Care

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 05D0574214

Southern California Primary Care Medical Group, Inc · Lake Elsinore, CA
Active · expires Aug 31, 2026
CLIA Number05D0574214
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMohammad R. Damesh MD
Laboratory Phone(951) 244-3500
Laboratory LocationSouthern California Primary Care Medical Group, Inc31581 Canyon Estates Dr, Lake Elsinore, CA 92532
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RYAN JACOBS PA-C
Physician Assistant (Medical)
31581 CANYON ESTATES DR
LAKE ELSINORE, CA 92532
Riverside County (951) 244-3500
VINCENT LIERAS PA
Physician Assistant
31581 CANYON ESTATES DR
LAKE ELSINORE, CA 92532
Riverside County (951) 244-3500
KUN SAVILLE
Physician Assistant
31581 CANYON ESTATES DR
LAKE ELSINORE, CA 92532
Riverside County (951) 244-3500
SOUTHERN CALIFORNIA PRIMARY CARE CANYON LAKE URGENT & FAMILY CARE
Non-Pharmacy Dispensing Site
31581 CANYON ESTATES DR
LAKE ELSINORE, CA 92532
Riverside County (951) 244-3500
NAVDEEP KAUR GILL PA-C
Physician Assistant (Medical)
31581 CANYON ESTATES DR
LAKE ELSINORE, CA 92532
Riverside County (951) 244-3500
DR. MOHAMMAD REZA DANESH M.D.
Family Medicine
31581 CANYON ESTATES DR
LAKE ELSINORE, CA 92532
Riverside County (951) 244-3500

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 Care Medical Group, Inc's NPI number?

The NPI number for Southern California Primary Care Medical Group, Inc is 1376632281. It was assigned to this organization in the NPPES registry on October 11, 2006. The provider is doing business as Canyon Lake Urgent & Family Care.

Where is Southern California Primary Care Medical Group, Inc located?

Southern California Primary Care Medical Group, Inc is located at 31581 Canyon Estates Dr, Lake Elsinore, CA 92532. The listed phone number is (951) 244-3500.

What is Southern California Primary Care Medical Group, Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Southern California Primary Care Medical Group, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0574214) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern California Primary Care Medical Group, Inc was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.