Healthcare Provider Details

I. General information

NPI: 1235386715
Provider Name (Legal Business Name): DIGESTIVE & LIVER DISEASES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1385 HALIFAX DR
RIVERSIDE CA
92506-4017
US

IV. Provider business mailing address

1385 HALIFAX DR
RIVERSIDE CA
92506-4017
US

V. Phone/Fax

Practice location:
  • Phone: 623-262-1171
  • Fax:
Mailing address:
  • Phone: 623-262-1171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number024657
License Number StateAZ

VIII. Authorized Official

Name: DR. RAWEL SINGH RANDHAWA
Title or Position: PRESIDENT
Credential: MD
Phone: 623-262-1171