Riverside Medical Imaging, L.L.C.

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

RIVERSIDE MEDICAL IMAGING, L.L.C.

Practice address

10111 Hole Ave
Riverside, CA 92503-3441

Phone

(951) 352-0555

Fax

(951) 352-9780

NPI assigned

Apr 5, 2006

Organization subpart

No

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

Authorized official

Name

Lisa Brockett

Title

Ceo

Phone

(949) 250-4500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1699737478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 HOLE AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033441",
            "telephone_number": "951-352-0555",
            "fax_number": "951-352-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10111 HOLE AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033441",
            "telephone_number": "951-352-0555",
            "fax_number": "951-352-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE MEDICAL IMAGING, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "BROCKETT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-250-4500"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverside Medical Clinic, Inc
• Riverside Medical Clinic, Inc
• Riverside Medical Clinic, Inc
• Riverside Medical Clinic, Inc
• Riverside Medical Clinic, Inc.
• Riverside Medical Supply
• Riverside Mental Health
• Riverside Natural Image LLC
• Riverside Neighborhood Health Center
• Riverside Nephrology Physicians Inc

• Physiological Laboratory in Riverside, CA
• Providers in Riverside, CA by specialty
• Physiological Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; 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.