Inland Empire Medical Group, Inc

Primary specialty

Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X

Legal business name

INLAND EMPIRE MEDICAL GROUP, INC

Practice address

10250 Country Club Dr Ste a
Jurupa Valley, CA 91752-1328

Phone

(952) 332-6360

Fax

(951) 332-0313

NPI assigned

Apr 22, 2019

Organization subpart

No

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

Authorized official

Name

Marc Stretten, MD

Title

Ceo

Phone

(714) 469-1690

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555891200000",
    "number": "1548823867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10250 COUNTRY CLUB DR STE A",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "917521328",
            "telephone_number": "951-332-6360",
            "fax_number": "951-332-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10250 COUNTRY CLUB DR STE A",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "917521328",
            "telephone_number": "952-332-6360",
            "fax_number": "951-332-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND EMPIRE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-22",
        "status": "A",
        "authorized_official_last_name": "STRETTEN",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-469-1690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "C35815",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adolescent Medicine (Family Medicine) Physician in Jurupa Valley, CA
• Providers in Jurupa Valley, CA by specialty
• Adolescent Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.