Pediatric Adolescent Clinic
Pediatric Adolescent Medicine
Pediatric Adolescent Clinic is a Upland, California based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
1214 Adriana Way, Upland, California - 91784-1742. They can be contacted on phone at
909-946-4155 and fax number 909-949-8836.
NPI number (Unique professional ID) for Pediatric Adolescent Clinic is
1164859385 which was assigned by NPPES on 02 Oct, 2013 and it was last updated on 02 Oct, 2013.
Pediatric Adolescent Clinic license number is
AFE33327 for Pediatrics Adolescent Medicine (2080A0000X) in California.
Pediatric Adolescent Clinic specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Pediatric Adolescent Clinic basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
|---|
| Provider Name : | Pediatric Adolescent Clinic |
|---|
Business Address:
Pediatric Adolescent Clinic address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1214 Adriana Way
Upland, CA, 91784-1742
United States |
|---|
| Phone Number : | 909-946-4155 |
|---|
| Fax Number : | 909-949-8836 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1164859385 |
|---|
| NPI Entity Type : | Organization |
|---|
| First Enrolment Date : | 02 Oct, 2013 |
|---|
| Last Updated On : | 02 Oct, 2013 |
|---|
Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Raoufaziz Ibrahim |
|---|
| Authorized Official Credential : | M.D. |
|---|
| Official Title or Position : | PEDIATRICIAN |
|---|
| Phone Number : | 909-946-4175 |
|---|
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Pediatric Adolescent Clinic are as mentioned. Primary taxonomy code for Pediatric Adolescent Clinic is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | AFE33327 | CA |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1214 Adriana Way
Upland, CA, 91784
United States |
|---|
| Phone Number : | 909-946-4155 |
|---|
| Fax Number : | 909-949-8836 |
|---|
Business Location:
Patients can refer following map for directions to
Pediatric Adolescent Clinic practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.