MEDICARE: FAMILY PLANNING ASSOCIATES MEDICAL GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician
2	261QA0005X	Ambulatory Family Planning Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	05D0668302	OTHER	CA	CLIA ID

General Provider Information

NPI Number	:	1427143734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY PLANNING ASSOCIATES MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	PO BOX 10818
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92423-0818
Country	:	US
Telephone Number	:	909-382-0201
Fax Number	:	909-495-1321

Provider Business Practice Location Address
First Line	:	501 S VINCENT AVE STE 205
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91790-6712
Country	:	US
Telephone Number	:	626-572-8800
Fax Number	:	909-495-1305

Authorized Official
Title or Position	:	OWNER
Name	:	DR. IRVING M. FELDKAMP IV IV
Credential	:	MD
Telephone Number	:	909-382-0201

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/29/2024

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