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Organization
INLAND EMPIRE MEDICAL NETWORK,INC.
Active
Organization
INLAND EMPIRE MEDICAL NETWORK,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE MANOS (CREDENTIALING)
(909) 398-1550
Entity
Organization
Contact information
Practice address
585 N MOUNTAIN AVE, SUITE C, UPLAND, CA 91786-8516
(909) 981-8599
(909) 981-5441
Mailing address
9140 HAVEN AVE, SUITE 110, RANCHO CUCAMONGA, CA 91730-5414
(909) 398-1550
(909) 398-1573
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/14/2010
Last updated
04/06/2011
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