Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brian Im, PA

Individual provider Physician Assistant · NPI 1700186491

Brian Im, PA is a Physician Assistant in Rancho Cucamonga, California. Qualified in 2014, 12 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
12
Licensed in
CA
In the registry since
2010
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

6417 Haven Ave Ste 110
Rancho Cucamonga, CA 91737-3804
Phone: (909) 941-2273
Fax: (909) 477-8830
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA21262 (CA)

Record details

NPI number1700186491
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedOctober 27, 2010
Last updated in NPPESMarch 6, 2026
Certification dateMarch 6, 2026
Mailing address6417 Haven Ave Ste 110, Rancho Cucamonga, CA 91737-3804

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Rancho Cucamonga