Provider Demographics
NPI:1467590323
Name:UNITED MEDICAL CARE CENTER INC.
Entity Type:Organization
Organization Name:UNITED MEDICAL CARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR / CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GROVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-327-4700
Mailing Address - Street 1:599 INLAND CENTER DR
Mailing Address - Street 2:# 114
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-1819
Mailing Address - Country:US
Mailing Address - Phone:909-327-4700
Mailing Address - Fax:562-943-7518
Practice Address - Street 1:599 INLAND CENTER DR
Practice Address - Street 2:# 114
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-1819
Practice Address - Country:US
Practice Address - Phone:909-327-4700
Practice Address - Fax:562-943-7518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CAC51338174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA148370Medicare PIN
CAW22367Medicare PIN