INFINITY MEDICAL GROUP INC. NPI 1962518407

NPI Information

NPI: 1962518407
Provider Name: INFINITY MEDICAL GROUP, INC.

Doing Business As: INFINITY PEDIATRICS

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
19333 BEAR VALLEY RD STE 201
APPLE VALLEY, CA
ZIP 92308
Phone: (760) 956-8700
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INFINITY MEDICAL GROUP, INC. is a primary care clinic center in Apple Valley, CA. INFINITY MEDICAL GROUP, INC. NPI is 1962518407. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Infinity Pediatrics.

The provider's business location address is:

19333 BEAR VALLEY RD STE 201
APPLE VALLEY, CA
ZIP 92308-150
Phone: (760) 956-8700
Fax: (760) 240-4445

The provider's authorized official is David Sungho Ahn .
The authorized official title is Ceo and has the following contact phone number (760) 956-8700.

The CLIA number assigned to this NPI record is 05D1004362 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/21/2006 and was last updated on 3/2/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		A61137	CALIFORNIA	No
2	261QP2300X	Clinic/Center	Primary Care	A61137	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00A611370	MEDICAID	CALIFORNIA

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: 5/5/2024

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