Healthcare Provider Details

I. General information

NPI: 1811438997
Provider Name (Legal Business Name): RATTNER VASCULAR MEDICAL CENTER ASC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2017
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4334 CENTRAL AVE
RIVERSIDE CA
92506-2918
US

IV. Provider business mailing address

PO BOX 419809
BOSTON MA
02241-9809
US

V. Phone/Fax

Practice location:
  • Phone: 951-248-1291
  • Fax: 951-992-1454
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: DALIA DAWOUD
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 951-248-1291