NPIMap

Organization Active NPI

Our Family Medical Group, Inc.

  • Gastroenterology Physician
  • Chino, CA
National Provider Identifier
1982419081
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
OUR FAMILY MEDICAL GROUP, INC.
Practice address
5475 Walnut Ave
1St Floor, Suite H
Chino, CA 91710-2609
Phone
(909) 591-6446
Fax
(909) 591-1309
NPI assigned
Feb 7, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Angelica K Aldaraca
Title
Credentialing Manager
Phone
(909) 236-7994

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

5475 Walnut Ave
1St Floor, Suite H
Chino, CA 91710-2609

Mailing address

840 Towne Center Dr
Pomona, CA 91767-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170106001779 CA Part B Supplier - Clinic/Group Practice 8729369665 Receives reassigned benefits from 10 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chino, CA; Ontario, CA; Rancho Cucamonga, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Our Family Medical Group4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

5475 Walnut Ave
Fl 1
Chino, CA 91710
Phone (909) 591-6446

9190 Haven Ave
Ste 102
Rch Cucamonga, CA 91730
Phone (909) 527-8110

Practitioners & affiliated clinicians

Practitioners 11

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": "1738886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1982419081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 WALNUT AVE",
            "address_2": "1ST FLOOR, SUITE H",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102609",
            "telephone_number": "909-591-6446",
            "fax_number": "909-591-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR FAMILY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-07",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "ALDARACA",
        "authorized_official_first_name": "ANGELICA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "909-236-7994"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.