Organization
KAISER FONTANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOC PHAM MDA (DIRECTOR)
(909) 427-5000
Entity
Organization
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(801) 791-4514
Mailing address
1607 INDEPENDENCE AVE, REDLANDS, CA 92374
(801) 791-4514
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
806523
CA
284300000X
Special Hospital
Primary
806523
CA
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up