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Organization
FORMULA MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
FORMULA MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES KRIDER M.D (DOCTOR)
(760) 242-1234
Entity
Organization
Contact information
Practice address
18182 US HIGHWAY 18, SUITE 105, APPLE VALLEY, CA 92307-2200
(760) 242-1234
(760) 242-5527
Mailing address
18182 US HIGHWAY 18, SUITE 105, APPLE VALLEY, CA 92307-2200
(760) 242-1234
(760) 242-5527
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G48897
CA
Other
Enumeration date
07/18/2006
Last updated
05/14/2020
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