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Organization
PINNACLE MEDICAL GROUP, INC
Active
Organization
PINNACLE MEDICAL GROUP, INC
Active
Other names
OPTUM
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES S SABBAH M.D. (MEDICAL DIRECTOR)
(909) 357-1595
Entity
Organization
Contact information
Practice address
8110 MANGO AVE, FONTANA, CA 92335-3603
(909) 427-1303
Mailing address
P.O. BOX 12209, SAN BERNARDINO, CA 92424-2209
(909) 357-1595
(909) 357-1203
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
CA
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
CA
208000000X
Pediatrics Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ14739Z
MEDICARE ID PTAN
CA
Enumeration date
09/15/2009
Last updated
04/04/2023
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