Healthcare Provider Details

I. General information

NPI: 1275351926
Provider Name (Legal Business Name): COUNTY OF RIVERSIDE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2499 E LAKESHORE DR STE B
LAKE ELSINORE CA
92530-4411
US

IV. Provider business mailing address

2499 E LAKESHORE DR STE B
LAKE ELSINORE CA
92530-4411
US

V. Phone/Fax

Practice location:
  • Phone: 951-471-4200
  • Fax:
Mailing address:
  • Phone: 951-471-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: GEOFFREY WON-CHEN LEUNG
Title or Position: PUBLIC HEALTH OFFICER
Credential:
Phone: 951-358-5121