Healthcare Provider Details

I. General information

NPI: 1164095360
Provider Name (Legal Business Name): TSHRISTI RIJAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1688 N PERRIS BLVD BLDG S
PERRIS CA
92571-4709
US

IV. Provider business mailing address

5964 SYCAMORE CANYON BLVD APT 3054
RIVERSIDE CA
92507-0864
US

V. Phone/Fax

Practice location:
  • Phone: 951-688-9363
  • Fax:
Mailing address:
  • Phone: 909-936-3970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number106701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: