Healthcare Provider Details

I. General information

NPI: 1215131743
Provider Name (Legal Business Name): FELIX MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8990 GARFIELD STREET UNIT #8
RIVERSIDE CA
92503
US

IV. Provider business mailing address

8990 GARFIELD STREET UNIT #8
RIVERSIDE CA
92503
US

V. Phone/Fax

Practice location:
  • Phone: 951-248-0485
  • Fax: 951-248-9267
Mailing address:
  • Phone: 951-248-0485
  • Fax: 951-248-9267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberG75952
License Number StateCA

VIII. Authorized Official

Name: DR. ALLEN C FELIX
Title or Position: OWNER/DOCTOR
Credential: MD
Phone: 951-248-0485