SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
NPI 1689606196
Health Maintenance Organization in Fontana, CA

Active since July 07, 2006
9961 SIERRA AVE, FONTANA, CA 92335(909) 427-3910 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, Dec 29, 2020 (3 updates tracked since 2020).

About Southern California Permanente Medical Group NPPES

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

SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP (NPI 1689606196) is a healthcare organization registered as a health maintenance organization in Fontana, California and active in the NPI registry since July 2006. The organization lists Ramin Davidoff, Executive Medical Director, as its authorized official.

NPPES Registry Identity

NPI1689606196
Entity TypeOrganization
Primary Taxonomy302R00000X
Legal Business NameSOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
Location Address9961 SIERRA AVEFontana, CA 92335-6720
Mailing Address393 E Walnut St, 3rd Fl Phr Group & Provider EnrollmentPasadena, CA 91188-0001 · (626) 405-7914 · Fax (626) 405-4600
Organization SubpartNo
Authorized OfficialRamin DavidoffExecutive Medical Director · (877) 608-0044
Enumeration DateJuly 7, 2006
Last NPPES UpdateNovember 2, 20213 updates tracked since enumeration
NPPES CertifiedNovember 2, 2021
✔ NPI 1689606196 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.
9961 SIERRA AVE, Fontana, CA 92335

Other Identifiers 1

MedicaidZZZ41545ZCA

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 Permanente Medical Group 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 Southern California Permanente Medical Group, which bills Medicare for the services they deliver. Of these, 555 practice at this address and 1,177 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
Hospitalist
NPI 1104267053
9961 SIERRA AVE FL MOB26
Fontana, CA 92335
(909) 427-2608
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1871652479
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOS✔ Accepts MedicareSame address
Pediatric Medicine
NPI 1164593133
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOSSame address
Obstetrics/Gynecology
NPI 1376602987
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOSSame address
Emergency Medicine
NPI 1841348778
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOSSame address
Hospice/Palliative Care
NPI 1083762017
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOS✔ Accepts MedicareSame address
Diagnostic Radiology
NPI 1588981468
9961 SIERRA AVE DIAGNOSTIC IMAGING SERVICES
Fontana, CA 92335
(909) 427-3914
✔ PECOS✔ Accepts MedicareSame address
Vascular Surgery
NPI 1558438416
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOSSame address
Optometry
NPI 1720155567
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOS✔ Accepts MedicareSame address
Orthopedic Surgery
NPI 1760559678
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1568882298
9961 SIERRA AVE MAIN HOSPITAL, 5TH FLOOR, ROOM 5406
Fontana, CA 92335
(909) 427-5000
✔ PECOS✔ Accepts MedicareSame address
Certified Registered Nurse Anesthetist (CRNA)
NPI 1215314984
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-5000
✔ Accepts MedicareSame address
Pulmonary Disease
NPI 1306913223
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOS✔ Accepts MedicareSame address
Qualified Audiologist
NPI 1396804027
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-4396
✔ Accepts MedicareSame address
Interventional Radiology
NPI 1417180456
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-7724
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1760541403
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOS✔ Accepts MedicareSame address
Physical Medicine and Rehabilitation
NPI 1285773986
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOS✔ Accepts MedicareSame address
Urology
NPI 1114094117
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-3910
✔ PECOS✔ Accepts MedicareSame address
Psychiatry
NPI 1821557745
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-5000
✔ PECOS✔ Accepts MedicareSame address
Physical Therapist in Private Practice
NPI 1073731261
9961 SIERRA AVE
Fontana, CA 92335
(909) 427-4075
✔ Accepts MedicareSame address
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 1689606196. It was assigned to this organization in the NPPES registry on July 7, 2006.

Where is Southern California Permanente Medical Group located?

Southern California Permanente Medical Group is located at 9961 Sierra Ave, Fontana, CA 92335. The listed phone number is (909) 427-3910.

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, 555 practice at this address and 1,177 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.