Provider Demographics
NPI:1447639794
Name:INLAND RESPIRATORY DIAGNOSTICS
Entity type:Organization
Organization Name:INLAND RESPIRATORY DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GURDIP
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-503-4135
Mailing Address - Street 1:9668 MILLIKEN AVE
Mailing Address - Street 2:SUITE 104398
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6137
Mailing Address - Country:US
Mailing Address - Phone:323-503-4135
Mailing Address - Fax:310-848-1346
Practice Address - Street 1:9668 MILLIKEN AVE
Practice Address - Street 2:SUITE 104398
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6137
Practice Address - Country:US
Practice Address - Phone:323-503-4135
Practice Address - Fax:310-848-1346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43194207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty