Healthcare Provider Details

I. General information

NPI: 1497810428
Provider Name (Legal Business Name): INLAND OUTPATIENT CARE CENTERS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 09/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4217 LUTHER ST
RIVERSIDE CA
92506-2853
US

IV. Provider business mailing address

4217 LUTHER ST
RIVERSIDE CA
92506-2853
US

V. Phone/Fax

Practice location:
  • Phone: 951-788-2001
  • Fax: 951-788-1881
Mailing address:
  • Phone: 951-788-2001
  • Fax: 951-788-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM S BEAL
Title or Position: MEDICAL DIRECTOR
Credential: DPM
Phone: 951-788-2001