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Organization
INLAND PHYSICIANS SERVICE INC
Active
Organization
INLAND PHYSICIANS SERVICE INC
Active
Other names
Inland Region Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS ALLEN WOODBURY DO (MANAGING PHYSICAN PARTNER)
(909) 483-0505
Entity
Organization
Contact information
Practice address
9089 BASELINE ROAD, SUITE 100, RANCHO CUCAMONGA, CA 91730
(909) 483-0505
(909) 483-0508
Mailing address
9089 BASELINE ROAD, SUITE 100, RANCHO CUCAMONGA, CA 91730
(909) 483-0505
(909) 483-0508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA1449
MEDICARE RAILROAD
CA
05
—
GR0061231
—
CA
Enumeration date
08/30/2006
Last updated
08/22/2020
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