Inland Breast and Body Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

INLAND BREAST AND BODY SURGERY CENTER

Practice address

3333 Concours St
Building #1 Suite 1100
Ontario, CA 91764

Phone

(909) 563-3015

NPI assigned

Nov 1, 2021

Organization subpart

No

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

Authorized official

Name

Zachary Andreasen, BSN

Title

Director of Nursing

Phone

(909) 844-5837

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1689339186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 MARION RD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923746332",
            "telephone_number": "909-563-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 CONCOURS ST",
            "address_2": "BUILDING #1 SUITE 1100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91764",
            "telephone_number": "909-563-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND BREAST AND BODY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "ANDREASEN",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "909-844-5837",
        "authorized_official_credential": "BSN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Ontario, CA
• Providers in Ontario, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.