Provider Demographics
NPI:1669064366
Name:INLAND PHYSICIANS PULMONARY SERVICES
Entity type:Organization
Organization Name:INLAND PHYSICIANS PULMONARY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KHORRAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-626-1205
Mailing Address - Street 1:9525 MONTE VISTA AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2231
Mailing Address - Country:US
Mailing Address - Phone:909-626-1205
Mailing Address - Fax:909-625-1977
Practice Address - Street 1:637 N 13TH AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4906
Practice Address - Country:US
Practice Address - Phone:909-985-9321
Practice Address - Fax:909-985-0842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep MedicineGroup - Multi-Specialty