Riverside Medical Clinic, Inc
Organization Active NPI Family Medicine Physician · Murrieta, CA
NPI 1700295607 · NPPES record last updated Jun 9, 2025
Key facts
- NPI
- 1700295607
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- RIVERSIDE MEDICAL CLINIC, INC
- Practice address
- 25485 Medical Center Dr Ste 100
Murrieta, CA 92562-6927 - Phone
- (951) 683-6370
- NPI assigned
- Aug 5, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Anupam Gupta, MD
- Title
- Medical Director
- Phone
- (951) 683-6370
Other NPIs on the same Medicare enrollment 8
Corporate family (same tax ID) 7
Practitioners 52
-
Brian Paul Boynton, M.D.
-
Loi Doan, DO
-
Jennifer A. Ellstrom, C.NP
-
Corey H Everett, NP-C
-
Emily Fernandez-Bell, FNP-C
-
Fatima A Gauhar, MD
-
Prateek Jindal, DO
-
Korylea Johnson, FNP-C
-
Sunghee Kim, N.P.
-
Scott Hyunsoo Lee, M.D.
-
Tracy Leong, MD
-
John Liu, M.D.
-
Mary Ann Nyc, MD
-
Iwan Nyotowidjojo, M.D.
-
Ricardo Librado Olivo, M.D.
-
Albino Ong, M.D
-
Nataliya Borsiov Osorio, MSN, RN-BC, NP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2296655 | Riverside Medical Clinic - Murrieta | Certificate of waiver | Jan 2, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040517000880 | CA | Part B Supplier - Clinic/Group Practice | 2961492327 |
Receives reassigned benefits from 356 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Riverside, CA; Murrieta, CA; Eastvale, CA |
National Provider Directory
- Tax ID family
- Riverside Medical Clini
Locations
33040 Antelope Rd
Ste 113
Murrieta, CA 92563
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Obstetrics & Gynecology Physician |
207V00000X |
Addresses
Primary practice location
25485 Medical Center Dr Ste 100
Murrieta, CA 92562-6927
Mailing address
3660 Arlington Ave
Riverside, CA 92506-3912
Phone (951) 683-6370
Other names
- Riverside Medical Clinic
Other providers in Murrieta, CA
- Jenny Natalie Rivera
- Rachel Rivera
- Sarah Rivera
- Rosanna Rivero
- Dejion Rivers
- Riverside Recovery Reosurces
- Riverside Recovery Resources
- Riverside Recovery Resources
- Summer Rober
- Robert Kollmorgen DO Inc
All providers in Murrieta, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.