=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720967920
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALTHCARE MGMT SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2025
-----------------------------------------------------
Last Update Date | 09/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4234 RIVERWALK PKWY STE 140
-----------------------------------------------------
City | RIVERSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92505-3304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-688-8060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4234 RIVERWALK PKWY STE 140
-----------------------------------------------------
City | RIVERSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92505-3304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-688-8060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | ZACHARY NIA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 310-927-4305
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------