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Organization

FOOTHILL PEDIATRICS MEDICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KELLEY W GEORGE MD (PRESIDENT)
(209) 532-5524
Entity
Organization

Contact information

Practice address
12791 CABEZUT RD, SONORA, CA 95370-5926
(209) 532-5524
(209) 532-1513
Mailing address
12791 CABEZUT RD, SONORA, CA 95370-5926
(209) 532-5524
(209) 532-1513

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
02/24/2009
Last updated
02/24/2009
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