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NPI Code Detail

MEDICARE: INLAND HEALTHCARE GROUP, A MEDICAL CORPORATION

MEDICARE: INLAND HEALTHCARE GROUP, A MEDICAL CORPORATION
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
1208000000XPediatrics Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3ZZZ43253ZOTHERCABS/TRIWEST

General Provider Information

NPI Number : 1811166218
Entity Type Code : Organization
Provider Name (Legal Business Name) : INLAND HEALTHCARE GROUP, A MEDICAL CORPORATION
Provider Business Mailing Address
First Line : PO BOX 10488
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92423-0488
Country : US
Telephone Number : 888-344-9111
Fax Number : 909-335-7130
Provider Business Practice Location Address
First Line : 1800 MEDICAL CENTER DR
Second Line : SUITE 104
City : SAN BERNARDINO
State : CA
Zip : 92411-1218
Country : US
Telephone Number : 909-887-7688
Fax Number : 909-880-0180
Authorized Official
Title or Position : PRESIDENT
Name : DR. CAREY PAUL
Credential : M.D.
Telephone Number : 909-335-7171
Provider Enumeration Date : 02/29/2008
Last Update Date : 05/24/2011

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Directions to “INLAND HEALTHCARE GROUP, A MEDICAL CORPORATION ” Practice Location

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