Provider Demographics
NPI:1255609483
Name:ALFARO MCFIELD MEDICAL CLINIC INC.
Entity type:Organization
Organization Name:ALFARO MCFIELD MEDICAL CLINIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROMERO-ALFARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-880-9993
Mailing Address - Street 1:1800 WESTERN AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92411-1354
Mailing Address - Country:US
Mailing Address - Phone:909-880-9993
Mailing Address - Fax:909-880-9998
Practice Address - Street 1:1800 WESTERN AVE STE 305
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92411-1354
Practice Address - Country:US
Practice Address - Phone:909-880-9993
Practice Address - Fax:909-880-9998
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALFARO MCFIELD MEDICAL CLINIC INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-02
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100540208000000X, 282NC2000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No282NC2000XHospitalsGeneral Acute Care HospitalChildrenGroup - Multi-Specialty