Mi Care Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A86795

Legal business name

MI CARE INC

Practice address

3975 Jackson St
#206
Riverside, CA 92503-3901

Phone

(951) 588-7685

NPI assigned

Aug 31, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Michael S Provenghi, MD

Title

President

Phone

(951) 588-7658

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1346556107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5198 ARLINGTON AVE",
            "address_2": "#610",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042603",
            "telephone_number": "951-588-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 JACKSON ST",
            "address_2": "#206",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033901",
            "telephone_number": "951-588-7685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "PROVENGHI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-588-7658",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": "A86795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.