| Santa Rita Medical Center, Inc. | |
|
4950 San Bernardino St Ste 202 Montclair CA 91763-2328 | |
| (909) 626-8262 | |
| (909) 626-8272 |
| Full Name | Santa Rita Medical Center, Inc. |
|---|---|
| Speciality | Obstetrics & Gynecology - Obstetrics |
| Location | 4950 San Bernardino St Ste 202, Montclair, California |
| Authorized Official Name and Position | Phillip Adrian Ruiz (CEO, CFO) |
| Authorized Official Contact | 3233599204 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Rita Medical Center, Inc. 4950 San Bernardino St Ste 202 Montclair CA 91763-2328 Ph: (909) 626-8262 | Santa Rita Medical Center, Inc. 4950 San Bernardino St Ste 202 Montclair CA 91763-2328 Ph: (909) 626-8262 |
| NPI Number | 1922216647 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922216647 | NPI | - | NPPES |
| GR0092360 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A44599 (California) | Primary |
| 207VX0000X | Obstetrics & Gynecology - Obstetrics | C41437 (California) | Primary |
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