Healthcare Provider Details

I. General information

NPI: 1346170974
Provider Name (Legal Business Name): DAVID COBIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 SPRUCE ST STE A
RIVERSIDE CA
92507-2410
US

IV. Provider business mailing address

3700 QUARTZ CANYON RD SPC 33
JURUPA VALLEY CA
92509-1114
US

V. Phone/Fax

Practice location:
  • Phone: 951-396-6870
  • Fax:
Mailing address:
  • Phone: 951-542-0639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: