Organization
INLAND HEALTHCARE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA PERKO (CFO)
(909) 335-7171
Entity
Organization
Contact information
Practice address
7430 CHERRY AVE, SUITE 100, FONTANA, CA 92336-4255
(909) 829-4680
(909) 854-0260
Mailing address
PO BOX 10488, SAN BERNARDINO, CA 92423-0488
(888) 344-9111
(909) 335-7130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518136787
—
CA
05
—
1871543850
—
CA
Enumeration date
02/21/2008
Last updated
09/11/2009
Update your record
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