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Organization
FAMILY PRACTICE MEDICAL SERVICES, INC.
Active
Organization
FAMILY PRACTICE MEDICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDOLPH BETTS (PRESIDENT)
(626) 331-7369
Entity
Organization
Contact information
Practice address
274 W BADILLO ST, COVINA, CA 91723-1906
(626) 331-7369
Mailing address
PO BOX 801463, SANTA CLARITA, CA 91380-1463
(661) 295-0859
(661) 295-0862
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A25707
CA
208D00000X
General Practice Physician
A25707
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A25707
STATE LICENSE OF PRESIDENT
CA
Enumeration date
03/23/2009
Last updated
03/23/2009
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