Organization
CHANNELL FAMILY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA GUEVARA-CHANNELL M.D. (OWNER)
(909) 483-7836
Entity
Organization
Contact information
Practice address
8008 HAVEN AVE, SUITE 100, RANCHO CUCAMONGA, CA 91730-3070
(909) 483-1236
(909) 483-1463
Mailing address
8008 HAVEN AVE, SUITE 100, RANCHO CUCAMONGA, CA 91730-3070
(909) 483-1236
(909) 483-1463
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
Other
Enumeration date
05/27/2006
Last updated
04/26/2011
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