Provider Demographics
NPI:1609067099
Name:INLAND RHEUMATOLOGY MEDICALGROUP, INC.
Entity Type:Organization
Organization Name:INLAND RHEUMATOLOGY MEDICALGROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-982-0099
Mailing Address - Street 1:548 N 13TH AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4976
Mailing Address - Country:US
Mailing Address - Phone:909-982-0099
Mailing Address - Fax:
Practice Address - Street 1:548 N 13TH AVE STE 204
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4976
Practice Address - Country:US
Practice Address - Phone:909-982-0099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty