Riverside Plastic Surgery Associates Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G76953 Issued in CA

Legal business name

RIVERSIDE PLASTIC SURGERY ASSOCIATES INC.

Practice address

4605 Brockton Ave
Suite 200
Riverside, CA 92506-0106

Phone

(951) 781-4339

Fax

(951) 274-0985

NPI assigned

Nov 16, 2006

Last updated

Sep 9, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ben J. Childers, M.D.NPI 1932287471

Title

President Cfo

Phone

(951) 781-4339

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ben J. Childers, M.D.

  • Specialist
  • Riverside, CA
  • NPI 1932287471
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252454400000",
    "number": "1316010499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 BROCKTON AVE",
            "address_2": "SUITE 200",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060106",
            "telephone_number": "951-781-4339",
            "fax_number": "951-274-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 BROCKTON AVE",
            "address_2": "SUITE 200",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060106",
            "telephone_number": "951-781-4339",
            "fax_number": "951-274-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PLASTIC SURGERY ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2009-09-09",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT CFO",
        "authorized_official_telephone_number": "951-781-4339",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G76953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverside Neurology Inc
• Riverside Neurosurgical Associates
• Riverside Oncology PC (Riverside Oncology)
• Riverside Operations, LP (Westmont Village)
• Riverside Pharmacy & Compounding
• Riverside Postacute Care LLC
• Riverside Primary Care Clinic
• Riverside Primary Care Doctors-Inc
• Riverside Psychiatric Medical Group
• Riverside Radiation Oncology Medical Group

• Specialist in Riverside, CA
• Providers in Riverside, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.