SOUTHERN CALIFORNIA PRIMARY CARE MEDICAL GROUP, INC
NPI 1376632281
Family Medicine in Lake Elsinore, CA
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 lists Mohammad R Danesh, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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 Care Medical Group, 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 Care Medical Group, Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 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.
Is Southern California Primary Care Medical Group, Inc enrolled in Medicare?
Yes. Southern California Primary Care Medical Group, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern California Primary Care Medical Group, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Southern California Primary Care Medical Group, 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.
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 13 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.
# Southern California Primary Care Medical Group, Inc · NPI 1376632281
Family Medicine organization in Lake Elsinore, California. Organization record, active in the CMS NPPES registry since October 11, 2006.
## Identity
- **NPI:** 1376632281 (Entity type: Organization)
- **Enumerated:** October 11, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** Canyon Lake Urgent & Family Care (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Mohammad Danesh, DIRECTOR
## Practice location
- **Address:** 31581 CANYON ESTATES DR, Lake Elsinore, CA 92532-0424
- **Phone:** (951) 244-3500 · **Fax:** (951) 244-3535
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 2, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1376632281) · Data from the CMS NPPES public registry.