| |
918 W Foothill Blvd Suite A Upland CA 91786-3772 | |
(909) 893-5511 | |
(909) 985-0351 |
Full Name | |
---|---|
Speciality | Clinic/center |
Location | 918 W Foothill Blvd, Upland, California |
Authorized Official Name and Position | Jessica Chinen (VP OF FINANCE) |
Authorized Official Contact | 7146336373 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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801 E Katella Ave Anaheim CA 92805-6614 Ph: (714) 633-6373 | 918 W Foothill Blvd Suite A Upland CA 91786-3772 Ph: (909) 893-5511 |
NPI Number | 1528037041 |
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Provider Enumeration Date | 03/16/2006 |
Last Update Date | 10/20/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528037041 | NPI | - | NPPES |
CMM70417F | Other | CA | CLINIC/CENTER |
240000321 | Medicaid | CA | |
05D1042218 | Other | CA | CLIA WESTMINSTER LAB |
05D0666696 | Other | CA | CLIA ORANGE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 240000321 (California) | Primary |
261Q00000X | Clinic/center | (California) | Secondary |
John J Kim Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 629 N 13th Ave, Upland, CA 91786 Phone: 909-981-8905 Fax: 909-982-8051 | |
Inland Empire Medical Network,inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 585 N Mountain Ave, Suite C, Upland, CA 91786 Phone: 909-981-8599 Fax: 909-981-5441 | |
Karnavy Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 E 7th St, Ste. 2e, Upland, CA 91786 Phone: 909-982-8976 Fax: 909-920-3176 | |
Generoso S Nery M D Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1183 E Foothill Blvd, Suite 135, Upland, CA 91786 Phone: 909-931-1368 Fax: 909-931-1372 |