NPIMap

Organization Active NPI

Neonatology Medical Group, Inc.

Doing business as Fontana Family Medical Center

  • Legal Medicine
  • Fontana, CA
National Provider Identifier
1952351074
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
A78188 Issued in CA
Legal business name
NEONATOLOGY MEDICAL GROUP, INC.
Doing business as
Fontana Family Medical Center
Practice address
17264 Foothill Blvd
Fontana, CA 92335-9050
Phone
(909) 428-3900
Fax
(909) 428-3903
NPI assigned
May 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Fides P. EscobalNPI 1063793065
Title
Office Manager
Phone
(909) 428-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X A78188 CA Primary

Addresses

Primary practice location

17264 Foothill Blvd
Fontana, CA 92335-9050

Mailing address

17264 Foothill Blvd
Fontana, CA 92335-9050
Phone (909) 428-3900

Other identifiers 1

IdentifierTypeStateIssuer
00A296540OtherCAMEDI-CAL

Other names 1

  • Fontana Family Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Neonatology Medical Group Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

17264 Foothill Blvd
Fontana, CA 92335
Phone (909) 428-3900

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952351074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17264 FOOTHILL BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923359050",
            "telephone_number": "909-428-3900",
            "fax_number": "909-428-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17264 FOOTHILL BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923359050",
            "telephone_number": "909-428-3900",
            "fax_number": "909-428-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEONATOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ESCOBAL",
        "authorized_official_first_name": "FIDES",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "909-428-3900",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "A78188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00A296540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fontana Family Medical Center",
            "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 Aug 22, 2020; 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.