# BOLIVAR FAMILY MEDICAL CLINIC A MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1740507607
- **Authorized official:** ALVARO BOLIVAR MD (OWNER)
- **Authorized official phone:** (909) 888-5552

## Contact information

- **Practice address:** 598 N F ST, SAN BERNARDINO, CA 92410-3110
- **Practice address phone:** (909) 888-5552
- **Practice address fax:** (909) 884-7530
- **Mailing address:** 598 N F ST, SAN BERNARDINO, CA 92410-3110
- **Mailing address phone:** (909) 888-5552
- **Mailing address fax:** (909) 884-7530

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/30/2010
- **Last updated:** 05/22/2013