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General NPI Number Information
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NPI Number | 1265393292
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Entity Type | Organization
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Legal Business Name | RADIANCE HEALTH GROUP PC INLAND PRIMARYCARE
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 6485 DAY ST STE 103
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City | RIVERSIDE
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State | CA
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Zip | 92507-0930
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Country | US
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Telephone | 951-339-1005
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Fax |
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Provider Business Mailing Address
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Address Line | 6485 DAY ST STE 103
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City | RIVERSIDE
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State | CA
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Zip | 92507-0930
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER OF ENTITY
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Name | SHEKIBA SHAHABZADA
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Credential |
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Telephone | 951-339-1005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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