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General NPI Number Information
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NPI Number | 1326651688
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Entity Type | Organization
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Legal Business Name | NEBI PC
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 8175 LIMONITE AVE STE A
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City | RIVERSIDE
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State | CA
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Zip | 92509-6120
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Country | US
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Telephone | 310-948-6239
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Fax | 909-803-0067
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Provider Business Mailing Address
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Address Line | 8175 LIMONITE AVE STE A
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City | RIVERSIDE
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State | CA
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Zip | 92509-6120
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Country | US
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Telephone | 310-948-6239
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Fax | 909-803-0067
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH NEGUSSE
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Credential | MD
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Telephone | 310-948-6239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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