Provider Demographics
NPI:1922628460
Name:INLAND EMPIRE PHYSICIANS
Entity Type:Organization
Organization Name:INLAND EMPIRE PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-380-0606
Mailing Address - Street 1:334 VIA VERA CRUZ STE 251
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-2642
Mailing Address - Country:US
Mailing Address - Phone:517-303-6145
Mailing Address - Fax:
Practice Address - Street 1:334 VIA VERA CRUZ STE 251
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2642
Practice Address - Country:US
Practice Address - Phone:517-303-6145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-24
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty