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General NPI Number Information
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NPI Number | 1972633766
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Entity Type | Organization
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Legal Business Name | INLAND MIDWIFE SERVICES
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 12/16/2009
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Provider Practice Location Address
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Address Line | 1200 ARIZONA STREET SUITE A-5
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City | REDLANDS
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State | CA
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Zip | 92374-4538
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Country | US
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Telephone | 909-335-6241
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Fax | 909-335-6244
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Provider Business Mailing Address
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Address Line | 1200 ARIZONA STREET SUITE A-5
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City | REDLANDS
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State | CA
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Zip | 92374-4538
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Country | US
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Telephone | 909-335-6241
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Fax | 909-335-6244
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Authorized Official
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Title or Position | OWNER DIRECTOR
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Name | MRS. LEONETTE CLAYSON
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Credential | CNM, NP
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Telephone | 909-335-6241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number | 240000532
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License Number State | CA
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