| Organization Name: | INLAND PSYCHIATRIC MEDICAL GROUP INC |
| NPI Number: | 1154670008 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SYAM P KUNAM (CEO) |
| Mailing Address: | 58471 29 Palms Hwy Suite 201 Yucca Valley |
| State: | CA US |
| Postal Code: | 922845818 |
| Phone Number: | 9093353026 |
| Fax Number: | 9093353167 |
| NPI Enumeration Date: | 09/06/2012 |
| NPI Last Update Date: | 09/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |