Riverside Regional Pediatric Medical Group, Inc.
Organization Active NPI Specialist · Perris, CA
NPI 1902987142 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1902987142
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- RIVERSIDE REGIONAL PEDIATRIC MEDICAL GROUP, INC.
- Practice address
- 180 E 4TH St # C
Perris, CA 92570-2125 - Phone
- (951) 943-8899
- Fax
- (951) 943-4598
- NPI assigned
- Oct 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Guillermo Valenzuela, M.D
- Title
- President/Owner
- Phone
- (909) 580-6320
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- My Family Me Primary Care - Sunnymead
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
180 E 4TH St # C
Perris, CA 92570-2125
Mailing address
180 E 4TH St # C
Perris, CA 92570-2125
Phone (951) 943-8899
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0086162 | Other | CA | MEDI-CAL PROVIDER NUMBER |
Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.