Provider Demographics
NPI:1811794902
Name:INLAND EMPIRE ANESTHESIOLOGY A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:INLAND EMPIRE ANESTHESIOLOGY A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMMERLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-600-0288
Mailing Address - Street 1:40404 CALIFORNIA OAKS RD STE C
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5786
Mailing Address - Country:US
Mailing Address - Phone:951-600-0288
Mailing Address - Fax:888-818-3162
Practice Address - Street 1:40404 CALIFORNIA OAKS RD STE A
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5786
Practice Address - Country:US
Practice Address - Phone:951-304-0200
Practice Address - Fax:888-818-3162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-26
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty