Organization
INLAND CARDIOTHORACIC SURGICAL ASSOCIATES MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI L KING CMA (DIRECTOR OF OPERATIONS)
(909) 881-1614
Entity
Organization
Contact information
Practice address
401 E HIGHLAND AVE, SUITE 251, SAN BERNARDINO, CA 92404-3803
(909) 881-1614
(909) 881-2711
Mailing address
401 E HIGHLAND AVE, SUITE 251, SAN BERNARDINO, CA 92404-3803
(909) 881-1614
(909) 881-2711
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0049930
—
CA
Enumeration date
07/05/2006
Last updated
11/02/2007
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