Healthcare Provider Details

I. General information

NPI: 1225224389
Provider Name (Legal Business Name): RIVIERA MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 SAN MIGUEL DR SUITE 107
NEWPORT BEACH CA
92660-7853
US

IV. Provider business mailing address

360 SAN MIGUEL DR SUITE 107
NEWPORT BEACH CA
92660-7853
US

V. Phone/Fax

Practice location:
  • Phone: 949-760-8300
  • Fax:
Mailing address:
  • Phone: 949-760-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BRYAN C DOONAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 949-760-8300