Healthcare Provider Details

I. General information

NPI: 1013828011
Provider Name (Legal Business Name): BIG BEAR FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41945 BIG BEAR BLVD
BIG BEAR LAKE CA
92315-2030
US

IV. Provider business mailing address

PO BOX 3474
BIG BEAR CITY CA
92314-3474
US

V. Phone/Fax

Practice location:
  • Phone: 909-294-2393
  • Fax:
Mailing address:
  • Phone: 909-294-2393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: SARAH GRUMAN
Title or Position: CEO
Credential:
Phone: 650-223-4208