=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134073810
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DIGESTIVE INSTITUTE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/20/2026
-----------------------------------------------------
Last Update Date | 02/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4234 RIVERWALK PKWY STE 170
-----------------------------------------------------
City | RIVERSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92505-3390
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-927-3220
-----------------------------------------------------
Fax | 949-276-9631
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4234 RIVERWALK PKWY STE 170
-----------------------------------------------------
City | RIVERSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92505-3390
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-927-3220
-----------------------------------------------------
Fax | 949-276-9631
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SHARE HOLDER
-----------------------------------------------------
Name | RANDALL CORNATEANU
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 310-710-5871
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------