| Alav Medical Corporation | |
|
16465 Sierra Lakes Pkwy Ste 220 Fontana CA 92336-1242 | |
| (909) 434-1123 | |
| (909) 261-8082 |
| Full Name | Alav Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 16465 Sierra Lakes Pkwy, Fontana, California |
| Authorized Official Name and Position | Faramarz Alav (PRESIDENT) |
| Authorized Official Contact | 9092618082 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alav Medical Corporation 16465 Sierra Lakes Pkwy Ste 200 Fontana CA 92336-1242 Ph: (909) 429-2404 | Alav Medical Corporation 16465 Sierra Lakes Pkwy Ste 220 Fontana CA 92336-1242 Ph: (909) 434-1123 |
| NPI Number | 1104016468 |
|---|---|
| Provider Enumeration Date | 08/01/2007 |
| Last Update Date | 03/30/2018 |
| Medicare PECOS PAC ID | 1951481571 |
|---|---|
| Medicare Enrollment ID | O20080108000520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104016468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A74033 (California) | Primary |
| Provider Name | Faramarz Alav |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508825027 PECOS PAC ID: 6800806654 Enrollment ID: I20060425000326 |
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