Individual provider Active NPI

Eric R Fox, M.D.

  • Family Medicine Physician
  • Yucaipa, CA
National Provider Identifier
1629003991
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G63965 Issued in CA
Practice address
33758 Yucaipa Blvd
Yucaipa, CA 92399-2243
Phone
(909) 795-9747
Fax
(909) 797-3922
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G63965 CA Primary

Addresses

Primary practice location

33758 Yucaipa Blvd
Yucaipa, CA 92399-2243

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 335-4188

Other identifiers 1

IdentifierTypeStateIssuer
00G639650MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, GU2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081215000114 CA Practitioner - Family Practice 5890857502 Reassigns benefits to 2 organizations
I20220614000406 GU Practitioner - Family Practice 5890857502 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G63965CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare CurrentSince Jul 31, 2023 Accepting new patients
Neighborhood Healthcare CurrentSince Jul 31, 2023 Accepting new patients
Gurusamy Inc. Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Beaver Medical Group P C CurrentSince Aug 1, 1997 Accepting new patients
Beaver Medical Group P C Family Medicine CurrentSince Aug 1, 1997 Accepting new patients

Locations

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

41840 Enterprise Cir N
Temecula, CA 92590
Phone (951) 225-6400

33758 Yucaipa Blvd
Yucaipa, CA 92399
Phone (909) 795-9747

655 Harmon Loop Rd
Ste 102
Dededo, GU 96929
Phone (671) 727-8811

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1629003991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-335-4188",
            "fax_number": "909-335-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33758 YUCAIPA BLVD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992243",
            "telephone_number": "909-795-9747",
            "fax_number": "909-797-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "ERIC",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G63965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G639650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

Verify at the official NPI Registry.