Healthcare Provider Details

I. General information

NPI: 1487151098
Provider Name (Legal Business Name): QUADMED MEDICAL CLINICS OF CALIFORNIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 E CENTRAL AVE
SAN BERNARDINO CA
92408
US

IV. Provider business mailing address

W227N6103 SUSSEX RD
SUSSEX WI
53089-3969
US

V. Phone/Fax

Practice location:
  • Phone: 888-261-6210
  • Fax:
Mailing address:
  • Phone: 414-566-8400
  • Fax: 414-566-8400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEFFERSON HARMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 414-566-8400