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General NPI Number Information
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NPI Number | 1073632261
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Entity Type | Organization
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Legal Business Name | INLAND PULMONARY MEDICAL GROUP
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 9525 MONTE VISTA AVE STE 105
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City | MONTCLAIR
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State | CA
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Zip | 91763-2231
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Country | US
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Telephone | 909-626-1205
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Fax | 909-670-0473
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Provider Business Mailing Address
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Address Line | 9525 MONTE VISTA AVE # 105
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City | MONTCLAIR
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State | CA
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Zip | 91763-2231
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Country | US
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Telephone | 909-626-1205
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Fax | 909-625-1977
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Authorized Official
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Title or Position | PARTNER
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Name | SHAHRAM KHORRAMI
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Credential | MD
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Telephone | 909-626-1205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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