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Organization
FAMILY MEDICINE FACULTY MEDICAL GROUP INC.
Active
Organization
FAMILY MEDICINE FACULTY MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY EBERT MD (PRESIDENT)
(909) 580-1000
Entity
Organization
Contact information
Practice address
400 N PEPPER AVE, 6TH FLOOR, COLTON, CA 92324-1801
(909) 580-6230
Mailing address
400 N PEPPER AVE, 6TH FLOOR, COLTON, CA 92324-1801
(909) 580-6230
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ83425Z
—
CA
Enumeration date
01/24/2007
Last updated
08/22/2020
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