Organization Name: | FOOTHILL FAMILY MEDICAL CLINIC |
NPI Number: | 1336324847 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MUHAMMAD YAQUB (PRESIDENT) |
Mailing Address: | 13677 Foothill Blvd Q Fontana |
State: | CA US |
Postal Code: | 923350505 |
Phone Number: | 9098997800 |
Fax Number: | 9098993163 |
NPI Enumeration Date: | 01/03/2008 |
NPI Last Update Date: | 03/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 00A45127 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |