Ontario Family Medical Center Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3281697 Issued in CA

Legal business name

ONTARIO FAMILY MEDICAL CENTER INC

Practice address

3700 E. Inland Empire Blvd
Suite 250
Ontario, CA 91764-4906

Phone

(909) 483-1001

Fax

(909) 483-1063

NPI assigned

Jun 28, 2010

Last updated

Sep 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin S. Wilbur, MDNPI 1790758613

Title

Medical Director

Phone

(909) 483-1011

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

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.

• Benjamin Stuart Wilbur, M.D.

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1790758613
  NPD (past) Authorized official
• Susan T. Manabo, FNP

  • Family Nurse Practitioner
  • Mission Viejo, CA
  • NPI 1063437754
  NPD (past)
• Pierre Chung Wong, MD

  • Pediatric Cardiology Physician
  • Los Angeles, CA
  • NPI 1629176912
  NPD (past)

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316390400000",
    "number": "1447561162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 E. INLAND EMPIRE BLVD",
            "address_2": "SUITE 250",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644906",
            "telephone_number": "909-483-1001",
            "fax_number": "909-483-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 E. INLAND EMPIRE BLVD",
            "address_2": "SUITE 250",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644906",
            "telephone_number": "909-483-1001",
            "fax_number": "909-483-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONTARIO FAMILY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-28",
        "last_updated": "2011-09-19",
        "status": "A",
        "authorized_official_last_name": "WILBUR",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "909-483-1011",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "3281697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BUSINESS LICENSE",
            "identifier": "3281697",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ontario del Sol Adhc, LLC
• Ontario Dental Center
• Ontario Dialysis Center LLC (Ontario Dialysis)
• Ontario Dialysis Center, Inc.
• Ontario Dialysis Center,Inc
• Ontario Grove Healthcare & Wellness Centre, LP
• Ontario Health Clinic, LLC
• Ontario Holt Dialysis Center, Inc.
• Ontario Interventional Center
• Ontario Operating Company Inc (Ontario Healthcare Center)

• Family Medicine Physician in Ontario, CA
• Providers in Ontario, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.