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Contact Information

INLAND DERMATOLOGY MEDICAL GROUP INC
1666 NORTH WATERMAN AVENUE
SAN BERNARDINO, CA92404
 Phone: 909-886-4965
 Fax: 909-886-8555
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for INLAND DERMATOLOGY MEDICAL GROUP INC · (Female)

NPI # 1447327168
Status Active
Credentials
Entity Individual
Enumeration date 11/29/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • CA Medicaid ZZZ46881Z
  • CA Other 00A240290 PIN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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