Healthcare Provider Details

I. General information

NPI: 1467804633
Provider Name (Legal Business Name): INLAND RHEUMATOLOGY & OSTEOPOROSIS MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1238 E ARROW HWY
UPLAND CA
91786-4951
US

IV. Provider business mailing address

1238 E ARROW HWY
UPLAND CA
91786-4951
US

V. Phone/Fax

Practice location:
  • Phone: 909-982-0099
  • Fax: 909-931-0402
Mailing address:
  • Phone: 909-982-0099
  • Fax: 909-931-0402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ERIC C LEE
Title or Position: PRESIDENT
Credential: M. D.
Phone: 909-982-0099