Healthcare Provider Details

I. General information

NPI: 1427093277
Provider Name (Legal Business Name): INLAND FAMILY HEALTHCARE CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 03/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N EUCLID AVE SUITE B
UPLAND CA
91786-8322
US

IV. Provider business mailing address

300 N EUCLID AVE SUITE B
UPLAND CA
91786-8322
US

V. Phone/Fax

Practice location:
  • Phone: 909-920-9100
  • Fax: 909-920-9620
Mailing address:
  • Phone: 909-920-9100
  • Fax: 909-920-9620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA7234
License Number StateCA

VIII. Authorized Official

Name: MS. MARY DIAZ
Title or Position: MANAGER
Credential:
Phone: 909-920-9100