Organization Active NPI

Vinod Mishra MD Facg a Professional Corp

  • Gastroenterology Physician
  • Riverside, CA
National Provider Identifier
1396893863
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A38396 Issued in CA
Legal business name
VINOD MISHRA MD FACG A PROFESSIONAL CORP
Practice address
6958 Brockton Ave Ste 201
Riverside, CA 92506-3802
Phone
(951) 784-6790
Fax
(951) 784-9919
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Vinod Mishra, MD
Title
Owner
Phone
(951) 784-6790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X A38396 CA Primary

Addresses

Primary practice location

6958 Brockton Ave Ste 201
Riverside, CA 92506-3802

Mailing address

6958 Brockton Ave Ste 201
Riverside, CA 92506-3802
Phone (951) 784-6790

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396893863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6958 BROCKTON AVE STE 201",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063802",
            "telephone_number": "951-784-6790",
            "fax_number": "951-784-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6958 BROCKTON AVE STE 201",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063802",
            "telephone_number": "951-784-6790",
            "fax_number": "951-784-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINOD MISHRA MD FACG A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MISHRA",
        "authorized_official_first_name": "VINOD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-784-6790",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A38396",
            "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 Aug 22, 2020; 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.