Provider Demographics
NPI:1124561741
Name:FAMILY PLANNING ASSOCIATES MEDICAL GROUP INC
Entity Type:Organization
Organization Name:FAMILY PLANNING ASSOCIATES MEDICAL GROUP INC
Other - Org Name:FPA WOMEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRVING
Authorized Official - Middle Name:M
Authorized Official - Last Name:FELDKAMP IV
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:909-382-0201
Mailing Address - Street 1:PO BOX 10818
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92423-0818
Mailing Address - Country:US
Mailing Address - Phone:909-382-0201
Mailing Address - Fax:909-495-1321
Practice Address - Street 1:1700 LOMBARD ST
Practice Address - Street 2:SUITE 110
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-8211
Practice Address - Country:US
Practice Address - Phone:805-822-5879
Practice Address - Fax:909-494-7807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-30
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1124561741Medicaid
CA05D2129035OtherCLIA ID