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General NPI Number Information
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NPI Number | 1174760953
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Entity Type | Organization
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Legal Business Name | INLAND HEALTHCARE GROUP A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 17051 SIERRA LAKES PKWY SUITE 101
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City | FONTANA
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State | CA
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Zip | 92336-1274
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Country | US
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Telephone | 909-428-2040
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Fax | 909-428-2191
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Provider Business Mailing Address
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Address Line | PO BOX 10488
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City | SAN BERNARDINO
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State | CA
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Zip | 92423-0488
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Country | US
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Telephone | 888-344-9111
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Fax | 909-335-7130
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CAREY PAUL
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Credential | M.D.
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Telephone | 909-335-7171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal 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 | 208000000X
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Taxonomy Name | Pediatrics 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 | 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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