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General NPI Number Information
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NPI Number | 1942173406
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Entity Type | Organization
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Legal Business Name | THE REDEEMER GROUP SPC THE REDEEMER
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 2979 MUMFORD CT
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City | RIVERSIDE
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State | CA
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Zip | 92503-8807
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Country | US
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Telephone | 951-433-3863
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Fax | 951-475-6488
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Provider Business Mailing Address
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Address Line | 2979 MUMFORD CT
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City | RIVERSIDE
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State | CA
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Zip | 92503-8807
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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 | CEO
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Name | CHARITY EZEAMAMA
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Credential | P.A.
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Telephone | 909-268-4181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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