Provider Demographics
NPI:1740711324
Name:THE INSTITUTE OF TRAUMA AND ACUTE CARE INC
Entity type:Organization
Organization Name:THE INSTITUTE OF TRAUMA AND ACUTE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-338-9880
Mailing Address - Street 1:160 E. ARTESIA STREET
Mailing Address - Street 2:SUITE 310
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2922
Mailing Address - Country:US
Mailing Address - Phone:909-338-9880
Mailing Address - Fax:909-338-9883
Practice Address - Street 1:160 E. ARTESIA STREET
Practice Address - Street 2:SUITE 310
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2922
Practice Address - Country:US
Practice Address - Phone:909-338-9880
Practice Address - Fax:909-338-9883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute CareGroup - Multi-Specialty