Provider Demographics
NPI:1629356688
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 1:2915 TELEGRAPH AVE STE 101
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2069
Practice Address - Country:US
Practice Address - Phone:510-899-7099
Practice Address - Fax:909-494-7803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D2027532OtherCLIA ID