Provider Demographics
NPI:1801395173
Name:NEW BEGINNINGS MEDICAL GROUP, PC.
Entity Type:Organization
Organization Name:NEW BEGINNINGS MEDICAL GROUP, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LELANIE
Authorized Official - Middle Name:FUENTES
Authorized Official - Last Name:DENILA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-815-7340
Mailing Address - Street 1:7535 WEAVER ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-5922
Mailing Address - Country:US
Mailing Address - Phone:909-862-0771
Mailing Address - Fax:909-931-1346
Practice Address - Street 1:99 N SAN ANTONIO AVE STE 330
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-7415
Practice Address - Country:US
Practice Address - Phone:909-931-0446
Practice Address - Fax:909-931-1346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty