Organization
INLAND NEPHROLOGY MEDICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOSEPH BLAKELY (OFFICE MANAGER)
(909) 793-7500
Entity
Organization
Contact information
Practice address
251 CAJON ST, SUITE B, REDLANDS, CA 92373-5260
(909) 793-7500
(909) 792-7890
Mailing address
251 CAJON ST, SUITE B, REDLANDS, CA 92373-5260
(909) 793-7500
(909) 792-7890
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0080390
—
CA
Enumeration date
11/07/2006
Last updated
08/19/2021
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