# INLAND VALLEY INFECTIOUS DISEASE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598793531
- **Authorized official:** DR. DANIEL P GLUCKSTEIN M.D. (PRESIDENT)
- **Authorized official phone:** (760) 740-0799

## Contact information

- **Practice address:** 255 E BONITA AVE, POMONA, CA 91767-1923
- **Practice address phone:** (760) 740-0799
- **Practice address fax:** (760) 740-0799
- **Mailing address:** PO BOX 289007, SAN DIEGO, CA 92198-9007
- **Mailing address phone:** (760) 740-0799
- **Mailing address fax:** (760) 740-0799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | — | NULL | Yes |
| 207RI0200X | Infectious Disease Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/29/2006
- **Last updated:** 04/20/2008