# FAMILY PRACTICE MEDICAL GROUP OF SAN BERNARDINO, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144351545
- **Authorized official:** DR. RICHARD J MOYER M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (909) 883-8966

## Contact information

- **Practice address:** 1369 E HIGHLAND AVE, SAN BERNARDINO, CA 92404-4640
- **Practice address phone:** (909) 883-8966
- **Practice address fax:** (909) 881-1480
- **Mailing address:** 1369 E HIGHLAND AVE, SAN BERNARDINO, CA 92404-4640
- **Mailing address phone:** (909) 883-8966
- **Mailing address fax:** (909) 881-1480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 10/08/2008