Riverside Addiction Specialists, Inc.

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

Legal business name

RIVERSIDE ADDICTION SPECIALISTS, INC.

Practice address

4605 Brockton Ave Ste 100
Riverside, CA 92506-0107

Phone

(951) 830-5874

Fax

(951) 686-9409

NPI assigned

Nov 14, 2022

Last updated

Nov 14, 2022By 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

Dr. Ray Glendrange, MDNPI 1164484507

Title

President

Phone

(951) 830-5874

Specialties & licenses 1

Addresses

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.

• Ray Rogers Glendrange, M.D.

  • Ophthalmology Physician
  • Riverside, CA
  • NPI 1164484507
  NPD Authorized official

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1356059877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 BROCKTON AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060107",
            "telephone_number": "951-830-5874",
            "fax_number": "951-686-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 BROCKTON AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060107",
            "telephone_number": "951-830-5874",
            "fax_number": "951-686-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE ADDICTION SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "GLENDRANGE",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-830-5874",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rivercrest MRI, Inc.
• Rivercrest Physical Therapy, Inc.
• Ashley Lane Rivero, BS
• Riversiade County Dept. of Mental Health
• Riverside Acupuncture
• Riverside Adhc Inc (Health and Wellness Center)
• Riverside Anesthesia Partners Inc
• Riverside Artificial Limb & Brace Corp
• Riverside Care, Inc.
• Riverside Childrens Speech Services Inc

• Addiction Medicine (Preventive Medicine) Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Addiction Medicine (Preventive Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.