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Active NPI 1629694716 Individual Practitioner Male Practitioner

Vidal Luis Cordova

Physician Assistant • Colton, CA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Vidal Cordova is a certified Physician Assistant practicing in Colton, CA. With approximately 6 years of clinical experience since completing medical education in 2020, Vidal Cordova delivers high-quality medical care to the local community at 400 N PEPPER AVE.

Vidal Cordova is affiliated with Southern California Permanente Medical Group and accepts Medicare assignment.

Frequently performed procedures and clinical services include initial hospital care with moderate level of medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

400 N Pepper Ave

Colton, CA 923241801

Telephone 9095571600
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Colton, CA

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -3.1 yrs vs City Avg
City Avg: 9.1 Yrs
State Avg: 11.5 Yrs
Regional Practice Density
162 Specialists

Practicing in Colton, CA (14617 Statewide)

Telehealth Adoption Rate
4.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
63.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Cordova (6 Years) 6 Yrs
Colton Specialty Average (9.1 Years) 9.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
11 11 $483.00 $175.56

Medical Specialties & State Licenses

CMS Verified: 2020-09-16
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Southern California Permanente Medical Group

9449 Imperial Hwy, Downey, CA 902422814

Phone: 5624613000

Southern California Permanente Medical Group

9353 Imperial Hwy, Downey, CA 902422812

Phone: 5626579000

Southern California Permanente Medical Group

9333 Rosecrans Ave, Bellflower, CA 907062141

Phone: 5624613000

Southern California Permanente Medical Group

9333 Imperial Hwy, Downey, CA 902422812

Phone: 8009234040

Southern California Permanente Medical Group

4647 Zion Ave, San Diego, CA 921202507

Phone: 6195285000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Jonathan Allen , MD

Orthopaedic Surgery

NPI 1023215357

Doctor of Medicine (M.D.)

Andrew Rives , PA-C

Physician Assistant - Medical

NPI 1023487006

Physician Assistant (Certified)

Harold Neuendorff , OTRL, CHT

Occupational Therapist

NPI 1053452680

Occupational Therapist Registered & Licensed, Certified Hand Therapist

Dr. Christopher Mantik , MD

Physical Medicine & Rehabilitation

NPI 1053971978

Doctor of Medicine (M.D.)

Dr. Jason Solomon , MD

Orthopaedic Surgery - Hand Surgery

NPI 1063654374

Doctor of Medicine (M.D.)

Heiba Kebbas

Physical Therapist

NPI 1073978326

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location January 13, 2023

Registered at 400 N PEPPER AVE, COLTON, CA 923241801 (Tel: 9095571600)

📍
Updated Practice Location September 16, 2020

Registered at 400 N PEPPER AVE, COLTON, CA 923241819 (Tel: 9095571600)

NPI Profile Active June 24, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location June 24, 2020

Registered at 3960 W POINT LOMA BLVD STE H-111, SAN DIEGO, CA 921105643 (Tel: 6198718037)

📍
Updated Business Mailing Address June 24, 2020

Registered at 3960 W POINT LOMA BLVD STE H-111, SAN DIEGO, CA 921105643 (Tel: 6198718037)

👤
Provider Name / Credentials Updated June 24, 2020

Recorded as VIDAL CORDOVA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 24, 2020

Physician Assistant

🟢
Initial NPI Registration & Enumeration June 24, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1629694716
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 24, 2020
Last Update: January 13, 2023
Sole Proprietor: No

Mailing Address

3960 W Point Loma Blvd Ste H-111

San Diego, CA 921105643

Phone: 6198718037

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.