Healthcare Provider Details

I. General information

NPI: 1780008839
Provider Name (Legal Business Name): RIVERSIDE CITY COLLEGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 03/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 MAGNOLIA AVE
RIVERSIDE CA
92506-1299
US

IV. Provider business mailing address

4800 MAGNOLIA AVE
RIVERSIDE CA
92506-1299
US

V. Phone/Fax

Practice location:
  • Phone: 951-222-8151
  • Fax:
Mailing address:
  • Phone: 951-222-8151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AARON BROWN
Title or Position: ASSOCIATE VICE CHANCELLOR, FINANCE
Credential:
Phone: 951-222-8789