NPIMap

Organization Active NPI

Lieu Rupp, M.D. Inc.

  • Family Medicine Physician
  • Riverside, CA
National Provider Identifier
1962688614
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G064515 Issued in CA
Legal business name
LIEU RUPP, M.D. INC.
Practice address
4440 Brockton Ave Ste 100
Riverside, CA 92501-4026
Phone
(951) 369-0138
Fax
(951) 369-1028
NPI assigned
Jan 11, 2008
Last updated
Jan 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Authorized official

Name
Lieu Rupp, M.D.NPI 1508957127
Title
Owner
Phone
(951) 369-0138

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G064515 CA Primary

Addresses

Primary practice location

4440 Brockton Ave Ste 100
Riverside, CA 92501-4026

Mailing address

4440 Brockton Ave Ste 100
Riverside, CA 92501-4026
Phone (951) 369-0138

National Provider Directory

National Provider Directory

Locations

4440 Brockton Ave
Ste 100
Riverside, CA 92501
Phone (951) 369-0138

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1962688614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 BROCKTON AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014026",
            "telephone_number": "951-369-0138",
            "fax_number": "951-369-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 BROCKTON AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014026",
            "telephone_number": "951-369-0138",
            "fax_number": "951-369-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIEU RUPP, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "RUPP",
        "authorized_official_first_name": "LIEU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-369-0138",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G064515",
            "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 Jan 11, 2008; 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.