Provider Demographics
NPI:1275817736
Name:INLAND CARDIOLOGY HEART FAILURE CLINIC
Entity Type:Organization
Organization Name:INLAND CARDIOLOGY HEART FAILURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:B.
Authorized Official - Middle Name:DON
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-982-6500
Mailing Address - Street 1:1382 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4014
Mailing Address - Country:US
Mailing Address - Phone:909-982-6500
Mailing Address - Fax:909-920-0406
Practice Address - Street 1:1382 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4014
Practice Address - Country:US
Practice Address - Phone:909-982-6500
Practice Address - Fax:909-920-0406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39266207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA28854Medicare UPIN
CAZZZ20199ZMedicare PIN