Vidal Luis Cordova Jr.
NPI 1629694716ActiveIndividual· Physician Assistant· Colton, CA
Physician Assistant with Southern California Permanente Medical Group, practicing in Colton, California. Their prescriptions cost Medicare Part D more than their services did: $5,090 for 608 claims, against $1,303 paid for services in 2024. Lists Kaiser Foundation Hospital - San Diego as a hospital affiliation.
Overview
| NPI | 1629694716 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jun 24, 2020 |
| Last updated in NPPES | Jan 13, 2023 |
| Certified by provider | Sep 16, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (CA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 21 |
|---|---|
| Services billed | 32 across 13 procedure codes |
| Paid by Medicare | $1,303 |
Part D prescriptions in 2024
| Prescriptions (claims) | 608 · 673 30-day fills |
|---|---|
| Patients | 288 |
| Total drug cost | $5,090 |
| Generic share | 100% of claims |
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Southern California Permanente Medical GroupRedlands, CA · 11,293 clinicians
Hospital affiliation
- Kaiser Foundation Hospital - San DiegoSan Diego, CA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other physician assistants in Colton
- 1083918403
- 1124496997
- 1245600568
- 1245872282
- 1295965333
- 1316336522
- 1386119998
- 1386711158
- 1407263486
- 1518212299
- 1528252418
- 1730770942
All 161 physician assistants in Colton · All physician assistants in California