Healthcare Provider Details

I. General information

NPI: 1568449072
Provider Name (Legal Business Name): SAMUEL ROY ATIGA CATALON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6405 DAY ST
RIVERSIDE CA
92507-0901
US

IV. Provider business mailing address

6405 DAY ST
RIVERSIDE CA
92507-0901
US

V. Phone/Fax

Practice location:
  • Phone: 951-697-5444
  • Fax: 951-697-5471
Mailing address:
  • Phone: 951-697-5444
  • Fax: 951-697-5471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG56429
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: