Foothill Family Medical Clinic Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

00A45127 Issued in CA

Legal business name

FOOTHILL FAMILY MEDICAL CLINIC INC

Practice address

13677 Foothill Blvd
Q
Fontana, CA 92335-0505

Phone

(909) 899-7800

Fax

(909) 899-3163

NPI assigned

Jan 3, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Muhammad Yaqub, M.D

Title

President

Phone

(909) 899-7800

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hateem Siddiqui

  • Internal Medicine Physician
  • San Bernardino, CA
  • NPI 1487099669
  NPD (past)

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1336324847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13677 FOOTHILL BLVD",
            "address_2": "Q",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923350505",
            "telephone_number": "909-899-7800",
            "fax_number": "909-899-3163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13677 FOOTHILL BLVD",
            "address_2": "Q",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923350505",
            "telephone_number": "909-899-7800",
            "fax_number": "909-899-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILL FAMILY MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "YAQUB",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-899-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "00A45127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A451271",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fontana Physicians Associates a Medical Corporation (Fontana Clinica Medica Familiar)
• Fontana Treatment Center
• Fontana Unified School District
• Fontana Unified School District
• Fontana Unified School District
• Foothill Serenity Living LLC (Foothill Serenity Living)
• Formosa Health Corp (Base Line Pharmacy)
• Amy Foster, PHARM D
• Jevonne Foster
• Kathryn Mary Foster, OTR

• General Practice Physician in Fontana, CA
• Providers in Fontana, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.