San Rafael Community Medical Clinic

LBN: Foothill Community Medical Corporation
San Rafael Community Medical Clinic is an health care organization with primary practice located at 1126 W Mission Blvd , Pomona CA 91766-1342. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Foothill Community Medical Corporation can be contacted via phone (909) 865-2538, or through Carcamo, Rafael via phone (909) 865-2538.

Contact Information

Primary practice address
1126 W Mission Blvd Pomona CA 91766-1342
Phone: (909) 865-2538
Fax: (909) 865-2508
Website:
Map and Directions
Authorized official contact:
Name: Carcamo, Rafael Doctor of Medicine (MD)
Phone: (909) 865-2538

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 00A666750 California

Profile Details

NPI number 1104043835
LBN Legal business name Foothill Community Medical Corporation
DBA Doing business as San Rafael Community Medical Clinic
Authorized official Carcamo, Rafael Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 20th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104043835 NPPES
California MEDICAID GR0090561

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