Endeavor Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ENDEAVOR MEDICAL PC

Doing business as

ENDEAVOR MEDICAL PC

Practice address

7665 Creole PL Unit 3
Rancho Cucamonga, CA 91739-7503

Phone

(909) 484-2865

Fax

(909) 941-6974

NPI assigned

May 17, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lourdes Trigueros, CREDENTIALING

Title

Credentialing

Phone

(909) 262-6125

Specialties & licenses 2

Addresses

Other names 1

• ENDEAVOR MEDICAL PC Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1316638653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10722 ARROW RTE STE 304",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304811",
            "telephone_number": "909-262-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7665 CREOLE PL UNIT 3",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917397503",
            "telephone_number": "909-484-2865",
            "fax_number": "909-941-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDEAVOR MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "TRIGUEROS",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "909-262-6125",
        "authorized_official_credential": "CREDENTIALING"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENDEAVOR MEDICAL PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ENDEAVOR MEDICAL PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.