Organization Active NPI

Precise Telehealth of California, a Professional Corporation

  • General Practice Physician
  • Riverside, CA
National Provider Identifier
1205332343
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PRECISE TELEHEALTH OF CALIFORNIA, A PROFESSIONAL CORPORATION
Practice address
4482 Main Street Primary Location
Riverside, CA 92501-4144
Phone
(410) 862-0820
Fax
(884) 828-6164
NPI assigned
Apr 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Authorized official

Name
Michael Kerouac
Title
Ceo
Phone
(203) 524-9871

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

4482 Main Street Primary Location
Riverside, CA 92501-4144

Mailing address

22 W Padonia Rd Ste C241
Timonium, MD 21093-2237
Phone (203) 524-9871

National Provider Directory

National Provider Directory

Locations

4482 Main St
Riverside, CA 92501
Phone (410) 862-0820

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1205332343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 W PADONIA RD STE C241",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210932237",
            "telephone_number": "203-524-9871",
            "fax_number": "844-828-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4482 MAIN STREET PRIMARY LOCATION",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014144",
            "telephone_number": "410-862-0820",
            "fax_number": "884-828-6164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISE TELEHEALTH OF CALIFORNIA, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-05",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "KEROUAC",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-524-9871"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.