Healthcare Provider Details

I. General information

NPI: 1073444683
Provider Name (Legal Business Name): SHILOH OCEAN FELIX
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 INDIANA AVE STE 295
RIVERSIDE CA
92506-4287
US

IV. Provider business mailing address

340 S FARRELL DR STE A208
PALM SPRINGS CA
92262-7931
US

V. Phone/Fax

Practice location:
  • Phone: 760-202-4308
  • Fax:
Mailing address:
  • Phone: 760-202-4308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: