Organization
CLINICA GUADALUPANA DE ONTARIO MED GRP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANCISCO A JIMENEZ M.D. (MEDICAL DIRECTOR)
(909) 391-3616
Entity
Organization
Contact information
Practice address
308 N 2ND AVE, UPLAND, CA 91786-8325
(909) 920-9193
(909) 920-6019
Mailing address
308 N 2ND AVE, UPLAND, CA 91786-8325
(909) 920-9193
(909) 920-6019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A40070
CA
207Q00000X
Family Medicine Physician
Primary
A40305
CA
208000000X
Pediatrics Physician
G15628
CA
213E00000X
Podiatrist
E3702
CA
Other
Enumeration date
01/19/2007
Last updated
07/02/2012
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