Provider Type Icon

PRIMARY PEDIATRIC AND ADOLESCENT CLINIC INCORPORATED NPI 1326117516


NPI Information

NPI: 1326117516
Provider Name: PRIMARY PEDIATRIC AND ADOLESCENT CLINIC, INCORPORATED

Doing Business As: HAVEN FAMILY MEDICAL CENTER, INCORPORATED

Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
8599 HAVEN AVE
STE. 101
RANCHO CUCAMONGA, CA
ZIP 91730
Phone: (909) 466-8888
Get Directions

PRIMARY PEDIATRIC AND ADOLESCENT CLINIC, INCORPORATED is a preferred provider organization in Rancho Cucamonga, CA. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. PRIMARY PEDIATRIC AND ADOLESCENT CLINIC, INCORPORATED NPI is 1326117516. The provider is registered as an organization entity type.
The provider Is Doing Business As Haven Family Medical Center, Incorporated.

The provider's business location address is:

8599 HAVEN AVE
STE. 101
RANCHO CUCAMONGA, CA
ZIP 91730-849
Phone: (909) 466-8888
Fax: (909) 483-0164

The provider's authorized official is Falahyah Mokhtar .
The authorized official title is Office Manager and has the following contact phone number (909) 466-8888.

The enumeration date for this NPI number is 11/6/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305R00000XPreferred Provider OrganizationA33327CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.