Iam Medical Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A102218 Issued in CA

Legal business name

IAM MEDICAL CLINIC

Practice address

5250 University Pkwy
A
San Bernardino, CA 92407-7051

Phone

(909) 684-9334

Fax

(909) 463-1426

NPI assigned

Mar 16, 2013

Organization subpart

No

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

Authorized official

Name

Chioma Kalu, M.D

Title

Director

Phone

(909) 684-9334

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1363392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363392000000",
    "number": "1659613693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 UNIVERSITY PKWY",
            "address_2": "A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924077051",
            "telephone_number": "909-684-9334",
            "fax_number": "909-463-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 UNIVERSITY PKWY",
            "address_2": "A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924077051",
            "telephone_number": "909-684-9334",
            "fax_number": "909-463-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAM MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-16",
        "last_updated": "2013-03-16",
        "status": "A",
        "authorized_official_last_name": "KALU",
        "authorized_official_first_name": "CHIOMA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "909-684-9334",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A102218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336387018",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in San Bernardino, CA
• Providers in San Bernardino, 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 Mar 16, 2013; 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.