Unknown Individual – Family Medicine Physician, NPI 1710967377
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
9804, Foothill Boulevard, Cucamonga, Rancho Cucamonga, San Bernardino County, California, 91730, United States
RANCHO CUCAMONGA, CA 91730
Phone: (909) 466-5433
Fax: (909) 466-5499
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 91730)
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