Provider Demographics
NPI:1497810428
Name:INLAND OUTPATIENT CARE CENTERS INC.
Entity Type:Organization
Organization Name:INLAND OUTPATIENT CARE CENTERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:951-788-2001
Mailing Address - Street 1:4217 LUTHER ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2853
Mailing Address - Country:US
Mailing Address - Phone:951-788-2001
Mailing Address - Fax:951-788-1881
Practice Address - Street 1:4217 LUTHER ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2853
Practice Address - Country:US
Practice Address - Phone:951-788-2001
Practice Address - Fax:951-788-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31849ZMedicare ID - Type UnspecifiedMEDICARE
CAT11107Medicare UPIN