Healthcare Provider Details

I. General information

NPI: 1831007731
Provider Name (Legal Business Name): SUMMIT PHYSICIANS MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 MAGNOLIA AVE
RIVERSIDE CA
92501-4135
US

IV. Provider business mailing address

15338 CENTRAL AVE STE 121
CHINO CA
91710-7658
US

V. Phone/Fax

Practice location:
  • Phone: 714-209-8872
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: YAS CASEY
Title or Position: SECRETARY
Credential: MD
Phone: 714-209-8872