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Organization
NEONATOLOGY MEDICAL GROUP, INC.
Active
Organization
NEONATOLOGY MEDICAL GROUP, INC.
Active
Other names
Fontana Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FIDES P. ESCOBAL (OFFICE MANAGER)
(909) 428-3900
Entity
Organization
Contact information
Practice address
17264 FOOTHILL BLVD, FONTANA, CA 92335-9050
(909) 428-3900
(909) 428-3903
Mailing address
17264 FOOTHILL BLVD, FONTANA, CA 92335-9050
(909) 428-3900
(909) 428-3903
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
A78188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A296540
MEDI-CAL
CA
Enumeration date
05/11/2006
Last updated
08/22/2020
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