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General NPI Number Information
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NPI Number | 1376061572
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Entity Type | Organization
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Legal Business Name | INLAND EMPIRE NEPHROLOGY, INC.
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 01/29/2018
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Provider Practice Location Address
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Address Line | 400 N PEPPER AVE
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City | COLTON
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State | CA
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Zip | 92324-1801
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Country | US
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Telephone | 909-835-7946
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Fax |
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Provider Business Mailing Address
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Address Line | 6509 E PASEO DIEGO
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City | ANAHEIM
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State | CA
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Zip | 92807-5011
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Country | US
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Telephone | 909-835-7946
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | POOJA BADLANI
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Credential | MD
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Telephone | 909-835-7946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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