NPIMap

Organization Active NPI

San Marcos Medical Group

  • Occupational Medicine Clinic/Center
  • Fontana, CA
National Provider Identifier
1689717613
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
License
A040591 Issued in CA
Legal business name
SAN MARCOS MEDICAL GROUP
Doing business as
METROPOLITAN INDUSTRIAL MEDICAL CLINIC
Practice address
10444 Liveoak Ave.
Fontana, CA 92337-7219
Phone
(909) 770-8293
Fax
(909) 770-8298
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Authorized official

Name
Azer Rezk
Title
Administrator
Phone
(909) 376-7715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X A040591 CA Primary

Addresses

Primary practice location

10444 Liveoak Ave.
Fontana, CA 92337-7219

Mailing address

10444 Liveoak Ave.
Fontana, CA 92337-7219
Phone (909) 770-8293

Other identifiers 1

IdentifierTypeStateIssuer
A045091OtherCAMEDICAL LISCENCE

Other names 1

  • METROPOLITAN INDUSTRIAL MEDICAL CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Metropolitan Family Medical Clinic8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780272000000",
    "number": "1689717613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10444 LIVEOAK AVE.",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923377219",
            "telephone_number": "909-770-8293",
            "fax_number": "909-770-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10444 LIVEOAK AVE.",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923377219",
            "telephone_number": "909-770-8293",
            "fax_number": "909-770-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MARCOS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A",
        "authorized_official_last_name": "REZK",
        "authorized_official_first_name": "AZER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-376-7715"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "CA",
            "license": "A040591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LISCENCE",
            "identifier": "A045091",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "METROPOLITAN INDUSTRIAL MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.