Dlr Family Medicine Medical Group Pc | |
11985 4th St Ste 102 Yucaipa CA 92399-2727 | |
(909) 478-7951 | |
Not Available |
Full Name | Dlr Family Medicine Medical Group Pc |
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Speciality | Internal Medicine |
Location | 11985 4th St Ste 102, Yucaipa, California |
Authorized Official Name and Position | Darin L Rentz (PRESIDENT) |
Authorized Official Contact | 7209847566 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dlr Family Medicine Medical Group Pc 12 Calle Ameno San Clemente CA 92672-2346 Ph: (720) 984-7566 | Dlr Family Medicine Medical Group Pc 11985 4th St Ste 102 Yucaipa CA 92399-2727 Ph: (909) 478-7951 |
NPI Number | 1295501708 |
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Provider Enumeration Date | 11/27/2023 |
Last Update Date | 11/27/2023 |
Medicare PECOS PAC ID | 0345683082 |
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Medicare Enrollment ID | O20240208004379 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295501708 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Anita C Adorador |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780654624 PECOS PAC ID: 3678639580 Enrollment ID: I20090302000266 |
Provider Name | Rohit Hemant Godbole |
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Provider Type | Practitioner - Critical Care (intensivists) |
Provider Identifiers | NPI Number: 1861758823 PECOS PAC ID: 3476868803 Enrollment ID: I20150814012619 |
Provider Name | Kristina L Dhillon |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1508227976 PECOS PAC ID: 5395071708 Enrollment ID: I20190723002464 |
Provider Name | Brandon D Jensen |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1821476797 PECOS PAC ID: 3779892120 Enrollment ID: I20230622002648 |
Provider Name | Maria Juana Correa De Maldonado |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891479176 PECOS PAC ID: 8123489366 Enrollment ID: I20230803002249 |
Provider Name | Alaina M Helt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326740952 PECOS PAC ID: 5597104299 Enrollment ID: I20240415001184 |
Provider Name | Ivana J Bluhm |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770775058 PECOS PAC ID: 7416396981 Enrollment ID: I20240416004069 |
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