Provider Demographics
NPI:1336453950
Name:FRANCISCO J CUELLAR A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:FRANCISCO J CUELLAR A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:WOMEN MEDCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:CUELLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-784-2490
Mailing Address - Street 1:PO BOX 670
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-0670
Mailing Address - Country:US
Mailing Address - Phone:909-784-2490
Mailing Address - Fax:909-784-2493
Practice Address - Street 1:160 E ARTESIA ST STE 150
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2994
Practice Address - Country:US
Practice Address - Phone:909-784-2490
Practice Address - Fax:909-784-2493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76446207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1336102797Medicaid
CA00A764460Medicare UPIN