Organization
INLAND PHYSIATRY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANCE ZACHARY JOHNSON M.D. (PRESIDENT/CEO)
(951) 506-5049
Entity
Organization
Contact information
Practice address
900 E WASHINGTON ST STE 100, COLTON, CA 92324-4120
(951) 506-5049
(951) 296-1098
Mailing address
27475 YNEZ RD STE 342, TEMECULA, CA 92591-4612
(951) 506-5049
(951) 296-1098
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
A61529
CA
Other
Enumeration date
07/25/2006
Last updated
08/31/2013
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