NPIMap

Organization Active NPI

Inland Psychiatric Medical Group, Inc

  • Psychiatry Physician
  • Lake Elsinore, CA
National Provider Identifier
1720898109
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
INLAND PSYCHIATRIC MEDICAL GROUP, INC
Practice address
31571 Canyon Estates Dr
Lake Elsinore, CA 92532-0468
Phone
(909) 289-4075
Fax
(909) 363-8233
NPI assigned
Jan 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Amber Gutierrez
Title
Provider Relations
Phone
(909) 289-4075

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

31571 Canyon Estates Dr
Lake Elsinore, CA 92532-0468

Mailing address

1809 W Redlands Blvd
Redlands, CA 92373-8054
Phone (909) 289-4075

National Provider Directory

National Provider Directory
Tax ID family
Inland Psychiatric Medical Group Inc38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

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

View all 37

Locations

31571 Canyon Estates Dr
Lake Elsinore, CA 92532
Phone (951) 471-0200

NPI Registry JSON

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1720898109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 W REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738054",
            "telephone_number": "909-289-4075",
            "fax_number": "909-363-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31571 CANYON ESTATES DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320468",
            "telephone_number": "909-289-4075",
            "fax_number": "909-363-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND PSYCHIATRIC MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "PROVIDER RELATIONS",
        "authorized_official_telephone_number": "909-289-4075"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.