Family Wellness Medical Corporation

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

C38712 Issued in CA

Legal business name

FAMILY WELLNESS MEDICAL CORPORATION

Practice address

1909 S Waterman Ave
Suite 3
San Bernardino, CA 92408

Phone

(909) 886-8420

Fax

(909) 886-8409

NPI assigned

Oct 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Babatunde Adegbite Jumadu, MEDICAL DOCTOR

Title

President/Principal

Phone

(909) 886-8420

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1457530479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 S WATERMAN AVE",
            "address_2": "SUITE 3",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92408",
            "telephone_number": "909-886-8420",
            "fax_number": "909-886-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 S WATERMAN AVE",
            "address_2": "SUITE 3",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92408",
            "telephone_number": "909-886-8420",
            "fax_number": "909-886-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY WELLNESS MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "JUMADU",
        "authorized_official_first_name": "BABATUNDE",
        "authorized_official_middle_name": "ADEGBITE",
        "authorized_official_title_or_position": "PRESIDENT/PRINCIPAL",
        "authorized_official_telephone_number": "909-886-8420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MEDICAL DOCTOR"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "C38712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Planning Associates Medical Group Inc
• Family Practice Medical Group of San Bernardino, Inc
• Family Service Agency of Fontana
• Family Service Agency of San Bernardino
• Family Services of San Bernardino
• Jennifer Adel Farag, M.S.
• Neal Robert Farber, RPH
• Wagner De Luca Faria, DDS
• Fariborz Lalezarzadeh DO Inc
• Athena Christine Farmer

• Pediatric Adolescent Medicine Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Pediatric Adolescent Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.