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Contact Information

COLTON VALLEY MEDICAL GROUP
502 W VALLEY BLVD
COLTON, CA92324
 Phone: 909-825-3202
 Fax: 909-825-9375
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for COLTON VALLEY MEDICAL GROUP

NPI # 1801991450
LBN Legal business name COLTON VALLEY MEDICAL GROUP
Authorized official WAGIAN SUN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/14/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers
CA License # A23744
CA Medicaid 00A237440
CA Medicaid GR0041960
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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