Healthcare Provider Details

I. General information

NPI: 1215096169
Provider Name (Legal Business Name): INPATIENT SPECIALISTS MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 11/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12401 WASHINGTON BLVD
WHITTIER CA
90602-1006
US

IV. Provider business mailing address

407 W IMPERIAL HWY H-171
BREA CA
92821-4832
US

V. Phone/Fax

Practice location:
  • Phone: 562-365-3540
  • Fax: 714-990-2754
Mailing address:
  • Phone: 562-365-3540
  • Fax: 714-990-2754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFRY MARCUS GILL
Title or Position: PRESIDENT
Credential: MD
Phone: 562-365-3540