NPIMap

Organization Active NPI

Inland Empire Medical Network,Inc.

  • Family Medicine Physician
  • Upland, CA
National Provider Identifier
1043538010
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INLAND EMPIRE MEDICAL NETWORK,INC.
Practice address
585 N Mountain Ave
Suite C
Upland, CA 91786-8516
Phone
(909) 981-8599
Fax
(909) 981-5441
NPI assigned
May 14, 2010
Last updated
Apr 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laurie Manos
Title
Credentialing
Phone
(909) 398-1550

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Family Medicine Physician 207Q00000X NU Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU

Addresses

Primary practice location

585 N Mountain Ave
Suite C
Upland, CA 91786-8516

Mailing address

9140 Haven Ave
Suite 110
Rancho Cucamonga, CA 91730-5414
Phone (909) 398-1550

National Provider Directory

National Provider Directory
Tax ID family
Inland Empire Medical Network6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1043538010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9140 HAVEN AVE",
            "address_2": "SUITE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305414",
            "telephone_number": "909-398-1550",
            "fax_number": "909-398-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 N MOUNTAIN AVE",
            "address_2": "SUITE C",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868516",
            "telephone_number": "909-981-8599",
            "fax_number": "909-981-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND EMPIRE MEDICAL NETWORK,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-14",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "MANOS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "909-398-1550"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.