Healthcare Provider Details

I. General information

NPI: 1215494141
Provider Name (Legal Business Name): HOSPITALIST CORPORATION OF INLAND EMPIRE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date: 04/26/2023
Reactivation Date: 05/24/2023

III. Provider practice location address

1880 N ORANGE GROVE AVE
POMONA CA
91767-3006
US

IV. Provider business mailing address

1131 W 6TH ST STE 225
ONTARIO CA
91762-1117
US

V. Phone/Fax

Practice location:
  • Phone: 909-620-7200
  • Fax: 909-620-5800
Mailing address:
  • Phone: 909-236-7994
  • Fax: 909-236-7958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANGIE ALDARACA
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 909-236-7994