| Dlr Family Medicine Medical Group Pc | |
|
11985 4th St Ste 102 Yucaipa CA 92399-2727 | |
| (909) 478-7951 | |
| Not Available |
| Full Name | Dlr Family Medicine Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11985 4th St Ste 102, Yucaipa, California |
| Authorized Official Name and Position | Darin L Rentz (PRESIDENT) |
| Authorized Official Contact | 7209847566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dlr Family Medicine Medical Group Pc 12 Calle Ameno San Clemente CA 92672-2346 Ph: (720) 984-7566 | Dlr Family Medicine Medical Group Pc 11985 4th St Ste 102 Yucaipa CA 92399-2727 Ph: (909) 478-7951 |
| NPI Number | 1295501708 |
|---|---|
| Provider Enumeration Date | 11/27/2023 |
| Last Update Date | 11/27/2023 |
| Medicare PECOS PAC ID | 0345683082 |
|---|---|
| Medicare Enrollment ID | O20240208004379 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295501708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rohit Hemant Godbole |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861758823 PECOS PAC ID: 3476868803 Enrollment ID: I20150814012619 |
| Provider Name | Brandon D Jensen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821476797 PECOS PAC ID: 3779892120 Enrollment ID: I20230622002648 |
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