Healthcare Provider Details

I. General information

NPI: 1184337602
Provider Name (Legal Business Name): FAMILYFIRST FAMILY MEDICAL PRACTICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42135 10TH ST W STE 201
LANCASTER CA
93534-6093
US

IV. Provider business mailing address

42135 10TH ST W STE 201
LANCASTER CA
93534-6093
US

V. Phone/Fax

Practice location:
  • Phone: 661-341-3800
  • Fax: 661-341-3810
Mailing address:
  • Phone: 661-341-3800
  • Fax: 661-341-3810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MIDIAN LOPEZ
Title or Position: PRACTICE MANAGER
Credential:
Phone: 661-341-3800