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Contact Information

HAVEN FAMILY MEDICAL CENTER, INC.
8599 HAVEN AVE
STE 101
RANCHO CUCAMONGA, CA91730-4849
 Phone: 909-466-8888
 Fax: 909-483-0164
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for HAVEN FAMILY MEDICAL CENTER, INC.

NPI # 1427152834
LBN Legal business name HAVEN FAMILY MEDICAL CENTER, INC.
Authorized official ZAHER AZZAWI - (CEO/PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/08/2006
Last updated 01/07/2008 - About 18 years ago
Identifiers
CA License # A487430
CA Other A487430 BLUE CROSS BLUE SHIELD
CA Other 1349459 UNITED HEALTHCARE GROUP #
CA Other 1048460 UNITED MPIN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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