Organization
INLAND PSYCHIATRIC MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER GUTIERREZ (PROVIDER RELATIONS)
(909) 289-4075
Entity
Organization
Contact information
Practice address
1620 S GRAND AVE, GLENDORA, CA 91740-5433
(626) 335-1919
(626) 335-1911
Mailing address
1809 W REDLANDS BLVD, REDLANDS, CA 92373-8054
(909) 289-4075
(909) 363-8233
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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