Provider Demographics
NPI:1952464307
Name:INLAND EMPIRE OCCUPATIONAL MEDICAL GROUP INC.
Entity Type:Organization
Organization Name:INLAND EMPIRE OCCUPATIONAL MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:951-341-9333
Mailing Address - Street 1:3579 ARLINGTON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3915
Mailing Address - Country:US
Mailing Address - Phone:951-341-9333
Mailing Address - Fax:951-341-9330
Practice Address - Street 1:3579 ARLINGTON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3915
Practice Address - Country:US
Practice Address - Phone:951-341-9333
Practice Address - Fax:951-341-9330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care