DLR Family Medicine Medical Group PC
Organization Active NPI Internal Medicine Physician · Yucaipa, CA
NPI 1295501708 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1295501708
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- DLR FAMILY MEDICINE MEDICAL GROUP PC
- Practice address
- 11985 4TH St Ste 102
Yucaipa, CA 92399-2727 - Phone
- (909) 478-7951
- NPI assigned
- Nov 27, 2023
- Organization subpart
- No
Authorized official
- Name
- Darin L Rentz, DO
- Title
- President
- Phone
- (720) 984-7566
Practitioners 19
-
Muhammad Arif, MD
-
Xu Long He, D.O
-
Pei-Yuen Tang, D.O.
-
Avneet Kaur, MD
-
Maria Juana Correa de Maldonado, NURSE PRACTITIONER
-
Rohit Hemant Godbole, M.D.
-
Alaina Marie Helt, FNP
-
Balram S Khehra, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240208004379 | CA | Part B Supplier - Clinic/Group Practice | 0345683082 |
Receives reassigned benefits from 18 practitioners Practice locations: Yucaipa, CA; Redlands, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
11985 4TH St Ste 102
Yucaipa, CA 92399-2727
Mailing address
12 Calle Ameno
San Clemente, CA 92672-2346
Phone (720) 984-7566
Other providers in Yucaipa, CA
- Tyler Jason Denn-Thiele
- Theresa Marie Denolf
- Bhavesh Desai
- Faith Hope Love Devaux
- Amber Colleen Dexter
- Huy Van DO
- Domel Inc.
- Brandon L Dominguez
- Kofi N Donkor
- Sahil Anup Dosaj
All providers in Yucaipa, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.