MEDICARE: OPTUM CARE NETWORK-INLAND FACULTY MG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302R00000X	Health Maintenance Organization	44334241	CA

General Provider Information

NPI Number	:	1750455713
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTUM CARE NETWORK-INLAND FACULTY MG

Provider Business Mailing Address
First Line	:	952 S MOUNT VERNON AVE STE B
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-4224
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	952 S MOUNT VERNON AVE STE B
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-4224
Country	:	US
Telephone Number	:	909-433-9111
Fax Number	:	909-433-9199

Authorized Official
Title or Position	:	IPA-OPERATIONS MANAGER
Name	:	VALDEMAR LUCATERO
Credential	:
Telephone Number	:	909-815-4702

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	06/29/2022

Similar Medicare Providers

1790835031 — RAI CARE CENTERS OF COLTON, LLC
Practice Location Address:

952 S MOUNT VERNON AVE STE A
COLTON, CA
92324-4224

Practice Phone: 909-430-0930
Practice Fax: 909-430-0934

1174386866 — FRESENIUS MEDICAL CARE SAN BERNARDINO, LLC
Practice Location Address:

952 S MOUNT VERNON AVE STE C
COLTON, CA
92324-4224

Practice Phone: 909-804-3138
Practice Fax: 909-424-9791

1023713161 — EVELYN UGONNA EJINAKA RN
Practice Location Address:

1330 E COOLEY DR
COLTON, CA
92324-3905

Practice Phone: 909-458-1350
Practice Fax: 909-580-3705

1093554792 — JENNIFER ESQUEDA
Practice Location Address:

1461 E COOLEY DR STE 100
COLTON, CA
92324-3921

Practice Phone: 877-527-7227
Practice Fax:

1669113379 — AKASH PATEL
Practice Location Address:

1330 E COOLEY DR
COLTON, CA
92324-3905

Practice Phone: 909-580-3705
Practice Fax:

1659205847 — MS. CYNTHIA MARIE GARCIA
Practice Location Address:

923 OAK GLEN LN
COLTON, CA
92324-4548

Practice Phone: 909-307-4439
Practice Fax:

Directions to “OPTUM CARE NETWORK-INLAND FACULTY MG ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.