Healthcare Provider Details

I. General information

NPI: 1639894678
Provider Name (Legal Business Name): PARKVIEW COMMUNITY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9493 GARFIELD ST
RIVERSIDE CA
92503-3765
US

IV. Provider business mailing address

9493 GARFIELD ST
RIVERSIDE CA
92503-3765
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMEER OHRI
Title or Position: PRESIDENT
Credential: MD
Phone: 661-205-2700