Healthcare Provider Details

I. General information

NPI: 1487613766
Provider Name (Legal Business Name): INLAND CENTER MEDICAL GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 HAVEN AVE STE 210
RANCHO CUCAMONGA CA
91730-8551
US

IV. Provider business mailing address

9220 HAVEN AVE STE 210
RANCHO CUCAMONGA CA
91730-8551
US

V. Phone/Fax

Practice location:
  • Phone: 909-989-7551
  • Fax: 909-484-9900
Mailing address:
  • Phone: 909-989-7551
  • Fax: 909-484-9900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: GEETA PATEL
Title or Position: OWNER
Credential: MD
Phone: 909-989-7551