Provider Demographics
NPI:1265519466
Name:INLAND DURABLE MEDICAL EQUIPMENT &
Entity type:Organization
Organization Name:INLAND DURABLE MEDICAL EQUIPMENT &
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NAZISH
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-278-1222
Mailing Address - Street 1:1426 W 6TH ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3061
Mailing Address - Country:US
Mailing Address - Phone:951-278-1222
Mailing Address - Fax:951-278-9229
Practice Address - Street 1:1426 W 6TH ST
Practice Address - Street 2:SUITE 108
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3061
Practice Address - Country:US
Practice Address - Phone:951-278-1222
Practice Address - Fax:951-278-9229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5912480001Medicare NSC