Healthcare Provider Details

I. General information

NPI: 1821637984
Provider Name (Legal Business Name): OBLS & PHYSICIAN SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 BROCKTON AVE STE 105
RIVERSIDE CA
92501-4006
US

IV. Provider business mailing address

4500 BROCKTON AVE STE 105
RIVERSIDE CA
92501-4006
US

V. Phone/Fax

Practice location:
  • Phone: 951-784-4088
  • Fax: 951-754-4089
Mailing address:
  • Phone: 951-784-4088
  • Fax: 951-754-4089

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: REEKESH R PATEL
Title or Position: OWNER
Credential: MD
Phone: 909-965-2953