Organization · NPI-2
Inland Psychiatric Medical Group, INC
Psychiatry & Neurology, Psychiatry · Indio, CA
NPI number1346845013
StatusActive
Last updated in NPPESJan 7, 2021
Details
- NPI
- 1346845013
- Entity type
- Organization (NPI-2)
- Legal business name
- Inland Psychiatric Medical Group, INC
- Organization subpart
- No
- Enumeration date
- Dec 1, 2020
- Certification date
- Jan 7, 2021
- Last updated
- Jan 7, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | Yes |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 106H00000X | Marriage & Family Therapist | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | |
| 103T00000X | Psychologist | – | – |
Practice location
81709 Dr Carreon Blvd # B-4Indio, CA 92201-5509
Phone 760-330-5161 · Fax 760-407-6862
Mailing address
81709 Dr Carreon Blvd Ste C1Indio, CA 92201-5577
Phone 760-330-5161 · Fax 760-407-6862
Authorized official
Amber Gutierrez
Provider Relations
9092894075
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