Healthcare Provider Details

I. General information

NPI: 1699275644
Provider Name (Legal Business Name): SOLIMAN-RIZKALLA CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2018
Last Update Date: 03/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25815 BARTON RD
LOMA LINDA CA
92354-3893
US

IV. Provider business mailing address

1086 RANCHO VALENCIA DR
RIVERSIDE CA
92508-8727
US

V. Phone/Fax

Practice location:
  • Phone: 909-478-1100
  • Fax:
Mailing address:
  • Phone: 951-789-6339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberA55643
License Number StateCA

VIII. Authorized Official

Name: MR. MICHAEL AWAD
Title or Position: ADMINISTRATOR
Credential:
Phone: 909-576-3310