Individual provider Active NPI

Kimberly Tustison, MD

  • Obstetrics & Gynecology Physician
  • Corona, CA
National Provider Identifier
1063731297
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A131535 Issued in CA
Practice address
21634 Retreat Pkwy
Corona, CA 92883-6100
Phone
(951) 493-6814
Fax
(951) 826-8134
NPI assigned
May 27, 2010
Last updated
Apr 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A131535 CA Primary

Addresses

Primary practice location

21634 Retreat Pkwy
Corona, CA 92883-6100

Mailing address

21634 Retreat Pkwy
Corona, CA 92883-6100
Phone (951) 493-6814

Other practice location 1

3390 University Ave Ste 100
Riverside, CA 92501
Phone (844) 827-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140821002897 CA Practitioner - Obstetrics/Gynecology 9830327790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

25485 Medical Ctr Dr
Suite 100
Murrieta, CA 92562-6927
Phone (951) 683-6370

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 683-6370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A131535CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Apr 1, 2022 Accepting new patients
Riverside Medical Clinic, Inc Obstetrics & Gynecology Current Accepting new patients
Riverside Medical Clinic, Inc Obstetrics & Gynecology CurrentSince Sep 1, 2019 Accepting new patients
Riverside Medical Clinic, Inc CurrentSince Sep 1, 2019 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
RMC Surgery Center, LLC Past Accepting new patients

Locations

25485 Medical Center Dr
Ste 100
Murrieta, CA 92562
Phone (909) 461-8684

25500 Medical Center Dr
Murrieta, CA 92562
Phone (951) 696-6000

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

7160 Brockton Ave
Riverside, CA 92506
Phone (951) 782-3714

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1063731297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21634 RETREAT PKWY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928836100",
            "telephone_number": "951-493-6814",
            "fax_number": "951-826-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21634 RETREAT PKWY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928836100",
            "telephone_number": "951-493-6814",
            "fax_number": "951-826-8134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3390 University Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "92501",
            "country_code": "US",
            "telephone_number": "844-827-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUSTISON",
        "first_name": "KIMBERLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-27",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A131535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.