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BEAR MOUNTAIN FAMILY PRACTICE NPI 1720107592


NPI Information

NPI: 1720107592
Provider Name: BEAR MOUNTAIN FAMILY PRACTICE
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0573164

Address:
41945 BIG BEAR BLVD STE 200
BIG BEAR LAKE, CA
ZIP 92315
Phone: (909) 866-5868
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BEAR MOUNTAIN FAMILY PRACTICE is a family medicine in Big Bear Lake, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BEAR MOUNTAIN FAMILY PRACTICE NPI is 1720107592. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

41945 BIG BEAR BLVD STE 200
BIG BEAR LAKE, CA
ZIP 92315-030
Phone: (909) 866-5868
Fax: (909) 866-5860

The provider's authorized official is Christopher H. Fagan .
The authorized official title is President and has the following contact phone number (909) 866-5868.

The CLIA number assigned to this NPI record is 05D0573164 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/29/2007 and was last updated on 2/23/2021.


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
1207Q00000XFamily MedicineYes

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: 11/14/2023

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.