Organization
FRIENDLY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GURPAL S PHAGUDA MD (MD OWNER)
(760) 949-7000
Entity
Organization
Contact information
Practice address
15462 MAIN STREET, HESPERIA, CA 92345-3318
(760) 949-7000
(760) 949-3123
Mailing address
15462 MAIN STREET, HESPERIA, CA 92345-3318
(760) 949-7000
(760) 949-3123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
G71819
CA
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G71819
LICENSE NUMBER
—
05
—
GR0054500
—
CA
Enumeration date
04/24/2006
Last updated
10/21/2021
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