Provider Demographics
NPI:1760738066
Name:UNITED FAMILY PHYSICIANS, INC.
Entity Type:Organization
Organization Name:UNITED FAMILY PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:CHERNEY
Authorized Official - Last Name:MOYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-335-3627
Mailing Address - Street 1:210 S GRAND AVE
Mailing Address - Street 2:SUITE 415
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-4205
Mailing Address - Country:US
Mailing Address - Phone:626-335-3627
Mailing Address - Fax:626-335-3627
Practice Address - Street 1:210 S GRAND AVE
Practice Address - Street 2:SUITE 415
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-4205
Practice Address - Country:US
Practice Address - Phone:626-335-3627
Practice Address - Fax:626-335-4806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGU409AOtherMEDICARE PTAN