Organization
NEONATOLOGY MEDICAL GROUP, INC.
Active
Other names
Fontana Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FIDES P. ESCOBAL (OFFICE MANAGER)
(909) 428-3900
Entity
Organization
Contact information
Practice address
17264 FOOTHILL BLVD, FONTANA, CA 92335-9050
(909) 428-3900
(909) 428-3903
Mailing address
17264 FOOTHILL BLVD, FONTANA, CA 92335-9050
(909) 428-3900
(909) 428-3903
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
A78188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A296540
MEDI-CAL
CA
Enumeration date
05/11/2006
Last updated
08/22/2020
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