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HEACOCK HEALTH MEDICAL GROUP, INC.
NPI 1891251849
Clinic/Center - Urgent Care in Moreno Valley, CA

Active since February 14, 2019
24060 FIR AVE STE A, MORENO VALLEY, CA 92553(951) 247-8005(951) 247-8007 Get Directions Write a Review

NPPES record last updated: April 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Heacock Health Medical Group, Inc. NPPES

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

HEACOCK HEALTH MEDICAL GROUP, INC. (NPI 1891251849) is a healthcare organization registered as an urgent care in Moreno Valley, California and active in the NPI registry since February 2019. The organization lists Rafael Penunuri, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1891251849
Entity TypeOrganization
Primary Taxonomy261QU0200X
Legal Business NameHEACOCK HEALTH MEDICAL GROUP, INC.
Location Address24060 FIR AVE STE AMoreno Valley, CA 92553-2895
Mailing Address24060 Fir Ave Ste AMoreno Valley, CA 92553-2895 · (951) 247-8005 · Fax (951) 247-8007
Phone(951) 247-8005
Fax(951) 247-8007
Organization SubpartNo
Authorized OfficialRafael PenunuriMedical Director · (951) 247-8005
Enumeration DateFebruary 14, 2019
Last NPPES UpdateApril 15, 2025
NPPES CertifiedApril 15, 2025
✔ NPI 1891251849 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Urgent CareAmbulatory Health Care Facilities
Taxonomy Code261QU0200X
Also ListedFamily MedicineTaxonomy 207Q00000X
24060 FIR AVE STE A, Moreno Valley, CA 92553
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Other Identifiers 1

Medicaid1760896336CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

HENNA MOHAMMAD
Physician Assistant
24060 FIR AVE STE A
MORENO VALLEY, CA 92553
Riverside County (951) 247-8005
DIVINE OLUWATOSIN OJELADE NP
Nurse Practitioner (Family)
24060 FIR AVE STE A
MORENO VALLEY, CA 92553
Riverside County (951) 247-8005
MS. SHANNA SHANEEN JACKSON NP
Nurse Practitioner (Family)
24060 FIR AVE STE A
MORENO VALLEY, CA 92553
Riverside County (951) 247-8005

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 Heacock Health Medical Group, Inc.'s NPI number?

The NPI number for Heacock Health Medical Group, Inc. is 1891251849. It was assigned to this organization in the NPPES registry on February 14, 2019.

Where is Heacock Health Medical Group, Inc. located?

Heacock Health Medical Group, Inc. is located at 24060 Fir Ave Ste A, Moreno Valley, CA 92553. The listed phone number is (951) 247-8005.

What is Heacock Health Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.

When was this NPI record last updated?

The NPPES record for Heacock Health Medical Group, Inc. was last updated on April 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.