Provider Demographics
NPI:1235431172
Name:INSCRIPTIONS CHILDREN'S CLINIC
Entity Type:Organization
Organization Name:INSCRIPTIONS CHILDREN'S CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:FAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:951-813-3760
Mailing Address - Street 1:36243 INLAND VALLEY DR
Mailing Address - Street 2:SUITE #80
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-9549
Mailing Address - Country:US
Mailing Address - Phone:951-813-3760
Mailing Address - Fax:951-813-3761
Practice Address - Street 1:36243 INLAND VALLEY DR
Practice Address - Street 2:SUITE #80
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-9549
Practice Address - Country:US
Practice Address - Phone:951-813-3760
Practice Address - Fax:951-813-3761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9032208000000X
CA1669261Q00000X
CA16134363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty