| San Bernardino County | |
|
16888 Baseline Ave Fontana CA 92336-2083 | |
| (855) 422-8029 | |
| Not Available |
| Full Name | San Bernardino County |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 16888 Baseline Ave, Fontana, California |
| Authorized Official Name and Position | Amanda Melissa Moffitt (ADMINISTRATIVE SUPERVISOR I) |
| Authorized Official Contact | 9097770726 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Bernardino County 400 N Pepper Ave Colton CA 92324-1819 Ph: (909) 580-1000 | San Bernardino County 16888 Baseline Ave Fontana CA 92336-2083 Ph: (855) 422-8029 |
| NPI Number | 1730934415 |
|---|---|
| Provider Enumeration Date | 04/17/2024 |
| Last Update Date | 04/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730934415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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