Healthcare Provider Details

I. General information

NPI: 1427976265
Provider Name (Legal Business Name): RIVERSIDE SPECIALTY CARE MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 LIME ST STE 521
RIVERSIDE CA
92501-0918
US

IV. Provider business mailing address

3600 LIME ST STE 521
RIVERSIDE CA
92501-0918
US

V. Phone/Fax

Practice location:
  • Phone: 951-299-0117
  • Fax: 951-299-0117
Mailing address:
  • Phone: 951-299-0117
  • Fax: 951-299-0117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER BERRETT
Title or Position: MANAGER
Credential: MD
Phone: 951-299-0117