Healthcare Provider Details

I. General information

NPI: 1508507229
Provider Name (Legal Business Name): REMEDIAL PATIENTS CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 04/05/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 RIMPAU AVE STE 213
CORONA CA
92879-7522
US

IV. Provider business mailing address

1451 RIMPAU AVE STE 213
CORONA CA
92879-7522
US

V. Phone/Fax

Practice location:
  • Phone: 951-268-6272
  • Fax: 951-530-8973
Mailing address:
  • Phone: 951-268-6272
  • Fax: 951-530-8973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAFAEL PENUNURI
Title or Position: CEO
Credential: MD
Phone: 949-697-9951