Organization
FRIENDLY OB GYN MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHAKAR DIXIT MD (OWNER)
(951) 485-9133
Entity
Organization
Contact information
Practice address
12810 HEACOCK ST STE B105, MORENO VALLEY, CA 92553-3171
(951) 485-9133
Mailing address
12810 HEACOCK ST STE B105, MORENO VALLEY, CA 92553-3171
(951) 485-9133
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G71778
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0089980
—
CA
05
—
GR0089981
—
CA
05
—
GR0089982
—
CA
Enumeration date
08/26/2005
Last updated
01/13/2014
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