Organization
PREMIER FAMILY MEDICINE ASSOCIATES, INC
Active
Parent organization
PREMIER FAMILY MEDICINE ASSOCIATES,INC
Other names
PVHC at Pomona
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIER FAMILY MEDICINE ASSOCIATES,INC
Authorized official
TAMARA J WARNER (ADMIN COORDINATOR)
(909) 865-9501
Entity
Organization
Contact information
Practice address
1770 N ORANGE GROVE AVE STE 101, POMONA, CA 91767-3027
(909) 469-9494
(909) 469-2120
Mailing address
1770 N ORANGE GROVE AVE STE 101, POMONA, CA 91767-3027
(909) 469-9494
(909) 469-2120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00127095
POMONA BUSINESS LICENSE
CA
01
—
05D0931230
CLIA
CA
05
—
1912907114
—
CA
01
—
CG8716
RAILROAD MEDICARE
—
05
—
GR0083730
—
CA
01
—
ZZZ57392Z
BLUE SHIELD OF CALIFORNIA
—
Enumeration date
07/28/2005
Last updated
02/25/2026
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