Inland Empire Medical Group INC.
Family Medicine in Colton, CA. Organization (NPI-2).
NPI number1164063897
StatusActive
Last updated in NPPESOct 3, 2019
Details
- NPI
- 1164063897
- Entity type
- Organization (NPI-2)
- Legal business name
- Inland Empire Medical Group INC.
- Organization subpart
- No
- Enumeration date
- Oct 3, 2019
- Last updated
- Oct 3, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
1550 E Washington St # 101Colton, CA 92324-4624
Phone 800-418-0850
Mailing address
1550 E Washington St # 101Colton, CA 92324-4624
Phone 800-418-0850
Authorized official
Deron A Gilliard
Managing Partner
9095815447
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