NPIMap

Organization Active NPI

Riverside Medical Clinic, Inc

Doing business as Riverside Medical Clinic

  • Internal Medicine Physician
  • Riverside, CA
National Provider Identifier
1730180415
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RIVERSIDE MEDICAL CLINIC, INC
Doing business as
Riverside Medical Clinic
Practice address
7117 Brockton Ave
Riverside, CA 92506-2658
Phone
(951) 683-6370
NPI assigned
Aug 3, 2005
Last updated
Nov 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Authorized official

Name
Dr. Anupam Gupta, MDNPI 1407927452
Title
Medical Director
Phone
(951) 683-6370

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiac Rehabilitation Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC3500X
Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207KA0200X CA
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X CA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X CA Primary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X CA
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X CA
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X CA
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X CA
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X CA
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X CA
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X CA

Addresses

Primary practice location

7117 Brockton Ave
Riverside, CA 92506-2658

Mailing address

3660 Arlington Ave
Riverside, CA 92506-3987
Phone (951) 683-6370

Other names 1

  • Riverside Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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
O20251031003710 CA Part B Supplier - Intensive Cardiac Rehabilitation 2961492327 Receives reassigned benefits from 3 practitioners
Practice locations: Riverside, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730180415. Details of each certification follow.

Ambulatory surgical center certification: CCN 55C0001202

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
RIVERSIDE MEDICAL CLINIC SURGERY CENTER
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jun 3, 2011
Last certification
Jun 3, 2011
Ownership / control type
Proprietary
Facility address
7117 Brockton Avenue 2ND Floor Procedure Suite
Riverside, CA 92506

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0911853Riverside Medical Clinic Inc7117 Brockton Ave, Riverside, CA 92506Provider-performed microscopyFeb 3, 2028

National Provider Directory

National Provider Directory

Locations

2079 Compton Ave
Ste 101-A
Corona, CA 92881
Phone (951) 371-6600

21634 Retreat Pkwy
Fl 3
Corona, CA 92883

2815 S Main St
Ste 100
Corona, CA 92882

818 Magnolia Ave
Corona, CA 92879
Phone (562) 213-9978

818 Magnolia Ave
Fl 1
Corona, CA 92879

830 Magnolia Ave
Corona, CA 92879
Phone (951) 493-6815

33040 Antelope Rd
Murrieta, CA 92563

33040 Antelope Rd
#113114
Murrieta, CA 92563

19314 Jesse Ln
Riverside, CA 92508
Phone (951) 782-3640

19330 Jesse Ln
Ste 100
Riverside, CA 92508
Phone (844) 827-8000

3510 Adams St
Riverside, CA 92504
Phone (951) 782-5136

3801 University Ave
Riverside, CA 92501
Phone (909) 683-6370

4100 Central Ave
Ste 201
Riverside, CA 92506
Phone (951) 268-8840

6485 Day St
Riverside, CA 92507
Phone (951) 653-5291

6780 Indiana Ave
Ste 100
Riverside, CA 92506
Phone (951) 782-3090

7150 Brockton Ave
Riverside, CA 92506
Phone (951) 782-3818

7177 Brockton Ave
Riverside, CA 92506
Phone (909) 815-9553

9041 Magnolia Ave
Ste 204
Riverside, CA 92503

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 348

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.

View all 348

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763337600000",
    "number": "1730180415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 ARLINGTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063987",
            "telephone_number": "951-683-6370",
            "fax_number": "951-248-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-683-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "ANUPAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-683-6370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WC3500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Cardiac Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.