Healthcare Provider Details

I. General information

NPI: 1558668269
Provider Name (Legal Business Name): OASIS MEDICAL CENTER,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2011
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 E WASHINGTON ST SUITE 101
COLTON CA
92324-4624
US

IV. Provider business mailing address

32158 CAMINO CAPISTRANO # A267
SAN JUAN CAPISTRANO CA
92675-3720
US

V. Phone/Fax

Practice location:
  • Phone: 909-370-4400
  • Fax: 909-422-1588
Mailing address:
  • Phone: 951-744-4158
  • Fax: 951-742-5134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number00G431511
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA18105
License Number StateCA

VIII. Authorized Official

Name: DR. A J ROGERS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 951-744-4158