Provider Demographics
NPI:1013179290
Name:NEPHROLOGY ASSOCIATES OF INLAND EMPIRE
Entity Type:Organization
Organization Name:NEPHROLOGY ASSOCIATES OF INLAND EMPIRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-949-8866
Mailing Address - Street 1:299 W FOOTHILL BLVD
Mailing Address - Street 2:STE 212
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3804
Mailing Address - Country:US
Mailing Address - Phone:909-949-8866
Mailing Address - Fax:
Practice Address - Street 1:1818 N ORANGE GROVE AVE
Practice Address - Street 2:STE 205
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3028
Practice Address - Country:US
Practice Address - Phone:909-623-7355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty