Provider Demographics
NPI:1215131743
Name:FELIX MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:FELIX MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-248-0485
Mailing Address - Street 1:8990 GARFIELD STREET
Mailing Address - Street 2:UNIT #8
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503
Mailing Address - Country:US
Mailing Address - Phone:951-248-0485
Mailing Address - Fax:951-248-9267
Practice Address - Street 1:8990 GARFIELD STREET
Practice Address - Street 2:UNIT #8
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503
Practice Address - Country:US
Practice Address - Phone:951-248-0485
Practice Address - Fax:951-248-9267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75952207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1063456978OtherINDIVIDUAL NPI NUMBER
CA00G759520Medicare ID - Type Unspecified
CA1063456978OtherINDIVIDUAL NPI NUMBER