Healthcare Provider Details

I. General information

NPI: 1306930052
Provider Name (Legal Business Name): FAMILY PLANNING ASSOCIATES MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E COLORADO ST STE 420
GLENDALE CA
91205-5123
US

IV. Provider business mailing address

PO BOX 10818
SAN BERNARDINO CA
92423-0818
US

V. Phone/Fax

Practice location:
  • Phone: 818-502-1341
  • Fax: 909-494-7649
Mailing address:
  • Phone: 909-382-0201
  • Fax: 909-495-1321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. IRVING M. FELDKAMP IV IV
Title or Position: OWNER
Credential: MD
Phone: 909-382-0201