| Foothill Family Medical Clinic Inc | |
|
13677 Foothill Blvd Q Fontana CA 92335-0505 | |
| (909) 899-7800 | |
| (909) 899-3163 |
| Full Name | Foothill Family Medical Clinic Inc |
|---|---|
| Speciality | General Practice |
| Location | 13677 Foothill Blvd, Fontana, California |
| Authorized Official Name and Position | Muhammad Yaqub (PRESIDENT) |
| Authorized Official Contact | 9098997800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foothill Family Medical Clinic Inc 13677 Foothill Blvd Q Fontana CA 92335-0505 Ph: (909) 899-7800 | Foothill Family Medical Clinic Inc 13677 Foothill Blvd Q Fontana CA 92335-0505 Ph: (909) 899-7800 |
| NPI Number | 1336324847 |
|---|---|
| Provider Enumeration Date | 01/03/2008 |
| Last Update Date | 11/07/2023 |
| Medicare PECOS PAC ID | 4880752880 |
|---|---|
| Medicare Enrollment ID | O20081020000623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336324847 | NPI | - | NPPES |
| 00A451271 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 00A45127 (California) | Primary |
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