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General NPI Number Information
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NPI Number | 1467645762
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Entity Type | Organization
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Legal Business Name | IN YOUR BEST INTEREST MEDICAL CLINIC, INC.
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 08/21/2007
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Provider Practice Location Address
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Address Line | 1201 BROOKSIDE AVE
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City | REDLANDS
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State | CA
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Zip | 92373-4402
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Country | US
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Telephone | 909-798-3331
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 BROOKSIDE AVE
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City | REDLANDS
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State | CA
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Zip | 92373-4402
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Country | US
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Telephone | 909-798-3331
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. ALESANDRA WILSON
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Credential |
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Telephone | 909-798-3331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A046504
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | A046504
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License Number State | CA
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