Healthcare Provider Details

I. General information

NPI: 1861462640
Provider Name (Legal Business Name): ANTHONY FRANCIS FIREK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N WATERMAN AVE
SAN BERNARDINO CA
92404-5105
US

IV. Provider business mailing address

1700 N WATERMAN AVE
SAN BERNARDINO CA
92404-5105
US

V. Phone/Fax

Practice location:
  • Phone: 909-883-8611
  • Fax: 909-886-1798
Mailing address:
  • Phone: 909-883-8611
  • Fax: 909-886-1798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberG559560
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: