Provider Demographics
NPI:1144505801
Name:INLAND EMPIRE COLON AND RECTAL SURGEONS
Entity type:Organization
Organization Name:INLAND EMPIRE COLON AND RECTAL SURGEONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ESMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:GEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-307-0900
Mailing Address - Street 1:245 TERRACINA BLVD STE 211B
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4878
Mailing Address - Country:US
Mailing Address - Phone:909-307-0900
Mailing Address - Fax:909-307-0988
Practice Address - Street 1:3130 W OLYMPIC BLVD STE 340
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2494
Practice Address - Country:US
Practice Address - Phone:213-389-3881
Practice Address - Fax:909-307-0988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INLAND EMPIRE COLON AND RECTAL SURGEONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-13
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA064659208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty