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General NPI Number Information
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NPI Number | 1962568501
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Entity Type | Organization
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Legal Business Name | WOMEN'S MEDICAL GROUP OF UPLAND INC.
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 8263 GROVE AVE STE 204
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3107
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Country | US
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Telephone | 909-931-1033
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Fax | 909-981-8976
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Provider Business Mailing Address
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Address Line | 8263 GROVE AVE STE 204
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3107
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Country | US
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Telephone | 909-931-1033
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Fax | 909-981-8976
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ROBIN BAYLESS
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Credential |
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Telephone | 909-931-1033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A00041400
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License Number State | CA
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