Healthcare Provider Details

I. General information

NPI: 1336018167
Provider Name (Legal Business Name): AZUBUIKE FAMILY MEDICINE CLINIC, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N EUCLID AVE STE B
UPLAND CA
91786-8323
US

IV. Provider business mailing address

300 N EUCLID AVE STE B
UPLAND CA
91786-8323
US

V. Phone/Fax

Practice location:
  • Phone: 909-217-5427
  • Fax: 213-410-5188
Mailing address:
  • Phone: 909-217-5427
  • Fax: 213-410-5188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. AKACHI C AZUBUIKE
Title or Position: PRESIDENT
Credential: MD
Phone: 909-217-5427