Unknown Individual – Specialist, NPI 1770523375

Unknown Individual is a healthcare provider. based in Corona, California. specializing in Specialist. They hold a License No. G15641 (CA). The NPI Number for Unknown Individual is 1770523375

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1770523375
Phone
(267) 252-9743
Address
24611 PINE WAY
Deactivation Date
7 June 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience18
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Pine Valley Way, Corona, Riverside County, California, 92881, United States

    CORONA, CA 928834129

    Phone: (267) 252-9743

    Type: Mailing

  • 605, West Naomi Avenue, West Arcadia, Arcadia, Los Angeles County, California, 91007, United States

    ARCADIA, CA 91066

    Phone: (626) 445-8481

    Fax: (626) 574-9669

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92883)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1770523375 is assigned to Unknown Individual under the national enumeration system.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Other Service Providers. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Corona, California for Unknown Individual; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.