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General NPI Number Information
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NPI Number | 1467369512
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Entity Type | Organization
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Legal Business Name | FOOTHILL UROLOGY SPECIALISTS, A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 1818 N ORANGE GROVE AVE STE 101
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City | POMONA
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State | CA
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Zip | 91767-3028
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Country | US
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Telephone | 909-236-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 1818 N ORANGE GROVE AVE STE 101
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City | POMONA
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State | CA
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Zip | 91767-3028
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Country | US
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Telephone | 909-236-3333
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/SECRETARY
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Name | DR. MICHAEL CONSOLO
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Credential | DO
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Telephone | 626-215-4524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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