Healthcare Provider Details

I. General information

NPI: 1548118912
Provider Name (Legal Business Name): RIVERSIDE HEALTH SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4024 12TH ST
RIVERSIDE CA
92501-3561
US

IV. Provider business mailing address

4024 12TH ST
RIVERSIDE CA
92501-3561
US

V. Phone/Fax

Practice location:
  • Phone: 310-927-0785
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PEJMAN SOLAIMANI
Title or Position: CEO
Credential: MD
Phone: 310-927-4063