Healthcare Provider Details

I. General information

NPI: 1750037537
Provider Name (Legal Business Name): CARIDAD MEDICAL CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 N CENTRAL AVE
UPLAND CA
91786-4241
US

IV. Provider business mailing address

559 N CENTRAL AVE
UPLAND CA
91786-4241
US

V. Phone/Fax

Practice location:
  • Phone: 909-921-0700
  • Fax:
Mailing address:
  • Phone: 909-921-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARY DELMURO
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 909-921-0700