Inland Healthcare Group a Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INLAND HEALTHCARE GROUP A MEDICAL CORPORATION

Practice address

17051 Sierra Lakes Pkwy
Suite 101
Fontana, CA 92336-1274

Phone

(909) 428-2040

Fax

(909) 428-2191

NPI assigned

Jan 15, 2009

Organization subpart

Yes

Parent organization

INLAND HEALTHCARE GROUP A MEDICAL CORPORATIONAs reported in NPPES

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

Authorized official

Name

Dr. Carey Paul, M.D.

Title

President

Phone

(909) 335-7171

Specialties & licenses 3

Addresses

Other identifiers 6

Part of

Arrowwest Physician Ass

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Inland Healthcare Group a Medical Corporation

  • Family Medicine Physician
  • Highland, CA
  • NPI 1700836475
  NPPES parent name

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1174760953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10488",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230488",
            "telephone_number": "888-344-9111",
            "fax_number": "909-335-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 SIERRA LAKES PKWY",
            "address_2": "SUITE 101",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361274",
            "telephone_number": "909-428-2040",
            "fax_number": "909-428-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND HEALTHCARE GROUP A MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INLAND HEALTHCARE GROUP A MEDICAL CORPORATION",
        "enumeration_date": "2009-01-15",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "CAREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-335-7171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366516478",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174760953",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629231147",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265642052",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871543850",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508052010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inland Empire Spine
• Inland Empire Spine and Rehabilitation Medical Center
• Inland Healthcare Group
• Inland Healthcare Group
• Inland Healthcare Group
• Inland MRI LLC
• Inland OB/GYN Associates, a Medical Corporation
• Inland Optometric Associates
• Inland Physical Therapy and Spine Center, PC
• Jerrelyn Javier Inocencio-Diaz, MD

• Family Medicine Physician in Fontana, CA
• Providers in Fontana, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.