NPIMap

Organization Active NPI

Inland Empire Medical Nertwork, Inc.

  • Family Medicine Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1215226642
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 NERTWORK, INC.
Practice address
9190 Haven Ave
1St Floor
Rancho Cucamonga, CA 91730-5431
Phone
(909) 581-6732
Fax
(909) 581-6737
NPI assigned
Apr 6, 2011
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

9190 Haven Ave
1St Floor
Rancho Cucamonga, CA 91730-5431

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.

Locations

9190 Haven Ave
Fl 1
Rancho Cucamonga, CA 91730
Phone (909) 527-8110

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1215226642",
    "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": "9190 HAVEN AVE",
            "address_2": "1ST FLOOR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305431",
            "telephone_number": "909-581-6732",
            "fax_number": "909-581-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND EMPIRE MEDICAL NERTWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "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": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, 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.