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Organization
INTERNAL MEDICINE MEDICAL GROUP
Active
Organization
INTERNAL MEDICINE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ADRIEENE M WALKER (CONTRACTS ADMINISTRATOR)
(909) 398-1550
Entity
Organization
Contact information
Practice address
1866 N ORANGE GROVE AVE, SUITE 202, POMONA, CA 91767-3031
(909) 623-8796
Mailing address
INTERNAL MEDICINE MEDICAL GROUP, 840 TOWNE CENTER DRIVE, POMONA, CA 91767-5900
(909) 398-1550
(909) 398-1573
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0011290
—
CA
Enumeration date
10/16/2006
Last updated
10/19/2007
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