Provider Demographics
NPI:1578850921
Name:FOOTHILL AIDS PROJECT
Entity Type:Organization
Organization Name:FOOTHILL AIDS PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:TONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-482-2066
Mailing Address - Street 1:233 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4324
Mailing Address - Country:US
Mailing Address - Phone:909-482-2066
Mailing Address - Fax:909-482-2070
Practice Address - Street 1:364 ORANGE SHOW LN
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-2023
Practice Address - Country:US
Practice Address - Phone:909-884-2722
Practice Address - Fax:909-884-2732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC-1411314OtherSTATE REGISTRATION