OPTUM – NPI #1376876912
Family Medicine

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.

OPTUM is a provider located in FONTANA, CA. NPPES has assigned the NPI number 1376876912 to OPTUM on September 15, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “OPTUM” is a dba name, the actual legal business name for this organization is PINNACLE MEDICAL GROUP, INC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 3 years ago on Apr 04, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for OPTUM below.

NPI Profile for
PINNACLE MEDICAL GROUP, INC

NPI Number
1376876912
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PINNACLE MEDICAL GROUP, INC
Doing Business As (dba): OPTUM
Primary location
8110 MANGO AVE
FONTANA, CA 92335-3603
Phone: (909) 427-1303 Fax:
Mailing address
P.O. BOX 12209
SAN BERNARDINO, CA 92424-2209
Phone: (909) 357-1595 Fax: (909) 357-1203
Organization Subpart
No
Authorized Official
CHARLES SABBAH
MEDICAL DIRECTOR
Phone: (909) 357-1595
Updated
Certification Date
Apr 04, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for OPTUM

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherMEDICARE ID PTANCAZZZ14739Z
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
208000000X
- Pediatrics
CA
207R00000X
- Internal Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.