Healthcare Provider Details

I. General information

NPI: 1003856188
Provider Name (Legal Business Name): JEFFREY ROBERT UNGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 HAVEN AVE STE 230
RANCHO CUCAMONGA CA
91730-8565
US

IV. Provider business mailing address

9220 HAVEN AVE STE 230
RANCHO CUCAMONGA CA
91730-8565
US

V. Phone/Fax

Practice location:
  • Phone: 909-590-8409
  • Fax: 909-590-8695
Mailing address:
  • Phone: 909-484-2105
  • Fax: 909-590-8695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberG45569
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG45569
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: