Healthcare Provider Details

I. General information

NPI: 1841646718
Provider Name (Legal Business Name): ARISABEL CHING RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 MAGNOLIA AVE
RIVERSIDE CA
92501-4135
US

IV. Provider business mailing address

950 N DUESENBERG DR APT 10301
ONTARIO CA
91764-5949
US

V. Phone/Fax

Practice location:
  • Phone: 951-788-3000
  • Fax:
Mailing address:
  • Phone: 626-353-6958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1056430
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: