Unknown Individual – Family Medicine Physician, NPI 1104873215
Family Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
5475, Walnut Avenue, Chino, San Bernardino County, California, 91710, United States
CHINO, CA 917102609
Phone: (909) 591-6446
Fax: (909) 591-1309
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91710)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| Family Practice, General Practice | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| Physician Assistant | CA |
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