NPIMap

Organization Active NPI

County of Riverside- Community Health Agency

  • Family Medicine Physician
  • Corona, CA
National Provider Identifier
1316965163
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A54662 Issued in CA
Legal business name
COUNTY OF RIVERSIDE- COMMUNITY HEALTH AGENCY
Practice address
505 S Buena Vista Ave
Corona, CA 92882-1901
Phone
(951) 272-5445
Fax
(951) 272-5489
NPI assigned
Jul 18, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Michael Tweedell, M.P.H.
Title
Deputy Director
Phone
(951) 358-5222

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X CA
Family Medicine Physician 207Q00000X A54662 CA Primary

Addresses

Primary practice location

505 S Buena Vista Ave
Corona, CA 92882-1901

Mailing address

PO Box 7849
Riverside, CA 92513-7849
Phone (951) 358-5222

National Provider Directory

National Provider Directory
Tax ID family
Riverside County Mental Health Department245 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

505 S Buena Vista Ave
Corona, CA 92882
Phone (951) 272-5445

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1316965163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7849",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925137849",
            "telephone_number": "951-358-5222",
            "fax_number": "951-358-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S BUENA VISTA AVE",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928821901",
            "telephone_number": "951-272-5445",
            "fax_number": "951-272-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF RIVERSIDE- COMMUNITY HEALTH AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "TWEEDELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "951-358-5222",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.P.H."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A54662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.