Inland Ear Nose and Throat a Medical Group Inc

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

INLAND EAR NOSE AND THROAT A MEDICAL GROUP INC

Practice address

1030 E Foothill Blvd
Suite 101
Upland, CA 91786-4057

Phone

(909) 981-5859

Fax

(909) 981-8293

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Natee Poopat, M.D.NPI 1760492821

Title

President

Phone

(909) 981-5859

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Inland Ear Nose and Throat a Medical Group Inc

  • Ambulatory Surgical Clinic/Center
  • Upland, CA
  • NPI 1477502979

  7911987979

  Same PAC ID

Tax ID family

Foothill Ambulatory Surg Ctr2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Inland Ear Nose and Throat a Medical Group Inc

  • Ambulatory Surgical Clinic/Center
  • Upland, CA
  • NPI 1477502979
  NPD tax ID

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Natee Poopat, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Upland, CA
  • NPI 1760492821
  Medicare reassignment Authorized official
• Clara Man-Ching Olcott, M.D.

  • Otolaryngology Physician
  • Upland, CA
  • NPI 1215291612
  Medicare reassignment NPD
• Montra M Kanok, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Upland, CA
  • NPI 1003865593
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1073612784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 E FOOTHILL BLVD",
            "address_2": "SUITE 101",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864057",
            "telephone_number": "909-981-5859",
            "fax_number": "909-981-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E FOOTHILL BLVD",
            "address_2": "SUITE 101",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864057",
            "telephone_number": "909-981-5859",
            "fax_number": "909-981-8293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13768 Roswell Ave Ste 116",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917101402",
            "country_code": "US",
            "telephone_number": "909-464-1006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INLAND EAR NOSE AND THROAT A MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "POOPAT",
        "authorized_official_first_name": "NATEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-981-5859",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN, MEDICARE SOUTH",
            "identifier": "FM 480 A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Upland, CA
• Providers in Upland, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.