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FORMULA MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION
NPI 1710905690
Family Medicine in Apple Valley, CA

Active since July 18, 2006CLIA 05D0718394 · Waiver
18182 US HIGHWAY 18, SUITE 105, APPLE VALLEY, CA 92307(760) 242-1234(760) 242-5527 Get Directions Write a Review

NPPES record last updated: May 14, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Formula Medical Group A Professional Medical Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORMULA MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION (NPI 1710905690) is a healthcare organization registered as a family medicine in Apple Valley, California and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through May 20, 2028 and lists James Krider, Doctor, as its authorized official.

NPPES Registry Identity

NPI1710905690
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFORMULA MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION
Location Address18182 US HIGHWAY 18, SUITE 105Apple Valley, CA 92307-2200
Mailing Address18182 Us Highway 18, Suite 105Apple Valley, CA 92307-2200 · (760) 242-1234 · Fax (760) 242-5527
Phone(760) 242-1234
Fax(760) 242-5527
Organization SubpartNo
Authorized OfficialJames KriderDoctor · (760) 242-1234
Enumeration DateJuly 18, 2006
Last NPPES UpdateMay 14, 2020
NPPES CertifiedMay 14, 2020
✔ NPI 1710905690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · G48897
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
18182 US HIGHWAY 18, Apple Valley, CA 92307
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0718394

Formula Medical Group · Apple Valley, CA
Active · expires May 20, 2028
CLIA Number05D0718394
Laboratory TypePhysician Office
Certificate Effective DateMay 21, 2026
Certificate Expiration DateMay 20, 2028
Laboratory DirectorJames C. Krider MD
Laboratory Phone(760) 242-1234
Laboratory LocationFormula Medical Group18182 Highway 18 #105, Apple Valley, CA 92307
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES KRIDER M.D
Family Medicine
18182 US HIGHWAY 18, SUITE 105
APPLE VALLEY, CA 92307
San Bernardino County (760) 242-1234
DR. DAMODARA RAJASEKHAR M.D.
Pediatrics (Neonatal-Perinatal Medicine)
18182 US HIGHWAY 18, STE # 103
APPLE VALLEY, CA 92307
San Bernardino County (760) 242-3004

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Formula Medical Group A Professional Medical Corporation's NPI number?

The NPI number for Formula Medical Group A Professional Medical Corporation is 1710905690. It was assigned to this organization in the NPPES registry on July 18, 2006.

Where is Formula Medical Group A Professional Medical Corporation located?

Formula Medical Group A Professional Medical Corporation is located at 18182 Us Highway 18 Suite 105, Apple Valley, CA 92307. The listed phone number is (760) 242-1234.

What is Formula Medical Group A Professional Medical Corporation's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Formula Medical Group A Professional Medical Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0718394) is associated with this NPI, valid through May 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Formula Medical Group A Professional Medical Corporation was last updated on May 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.