Inland Psychiatric Medical Group INC
Psychiatry & Neurology, Psychiatry in Corona, CA. Organization (NPI-2).
NPI number1164169587
StatusActive
Last updated in NPPESMay 17, 2022
Details
- NPI
- 1164169587
- Entity type
- Organization (NPI-2)
- Legal business name
- Inland Psychiatric Medical Group INC
- Organization subpart
- No
- Enumeration date
- May 17, 2022
- Certification date
- May 17, 2022
- Last updated
- May 17, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | Yes |
| 103TC0700X | Psychologist, Clinical | – | – | |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 106H00000X | Marriage & Family Therapist | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
4160 Temescal Canyon Rd Ste 408Corona, CA 92883-4629
Phone 951-344-4451 · Fax 951-416-2252
Mailing address
1809 W Redlands BlvdRedlands, CA 92373-8054
Phone 909-289-4075 · Fax 909-363-8233
Authorized official
Amber Gutierrez
Provider Relations
9092894075
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