Provider Demographics
NPI:1295117299
Name:INLAND FACULTY SPECIALISTS, A CALIFORNIA PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:INLAND FACULTY SPECIALISTS, A CALIFORNIA PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:J
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-580-6333
Mailing Address - Street 1:PO BOX 1762
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-0857
Mailing Address - Country:US
Mailing Address - Phone:909-580-6333
Mailing Address - Fax:909-580-3289
Practice Address - Street 1:4153 RUBIDOUX AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-1717
Practice Address - Country:US
Practice Address - Phone:951-384-7311
Practice Address - Fax:951-342-3064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Multi-Specialty
No2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental DisabilitiesGroup - Multi-Specialty