Provider Demographics
NPI:1467402149
Name:INLAND OB-GYN ASSOCIATES A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:INLAND OB-GYN ASSOCIATES A MEDICAL CORPORATION
Other - Org Name:WOMEN'S HEALTH CENTER AT ST. BERNARDINE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHAUERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-882-4605
Mailing Address - Street 1:PO BOX 10488
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92423-0488
Mailing Address - Country:US
Mailing Address - Phone:909-335-7171
Mailing Address - Fax:909-335-7130
Practice Address - Street 1:401 E HIGHLAND AVE
Practice Address - Street 2:STE 450
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-3803
Practice Address - Country:US
Practice Address - Phone:909-882-4605
Practice Address - Fax:909-882-3265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA160056750OtherRR MCR
CA1881774479Medicaid
CA1467402149Medicaid
CA1528018488Medicaid
CAGR0090610Medicaid
CA1093806382Medicaid
CA1538119318Medicaid
CAGR0090610Medicaid
CA1528018488Medicaid
CA1093806382Medicaid
CA1881774479Medicaid