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NPI Code Detail

MEDICARE: PRIMARY CARE MEDICAL GROUP OF INLAND EMPIRE, INC

MEDICARE: PRIMARY CARE MEDICAL GROUP OF INLAND EMPIRE, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/CenterC2483376CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DA7622OTHERCARAIL ROAD PTAN

General Provider Information

NPI Number : 1255412474
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIMARY CARE MEDICAL GROUP OF INLAND EMPIRE, INC
Provider Business Mailing Address
First Line : 1998 N ARROWHEAD AVE
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92405-4116
Country : US
Telephone Number : 909-882-0988
Fax Number : 909-886-1301
Provider Business Practice Location Address
First Line : 1998 N ARROWHEAD AVE
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92405-4116
Country : US
Telephone Number : 909-882-0988
Fax Number : 909-886-1301
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. SUNIL ARORA
Credential : MD
Telephone Number : 909-882-0988
Provider Enumeration Date : 10/17/2006
Last Update Date : 08/12/2022

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