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General NPI Number Information
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NPI Number | 1972993624
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Entity Type | Organization
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Legal Business Name | RIVERSIDE COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 02/03/2015
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 4445 MAGNOLIA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92501-4135
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Country | US
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Telephone | 951-788-3636
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Fax | 951-788-3669
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Provider Business Mailing Address
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Address Line | PO BOX 31001-2130
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City | PASADENA
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State | CA
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Zip | 91110-2130
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Country | US
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Telephone | 213-412-1973
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Fax | 213-412-1981
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | JOHN A. HEYDT
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Credential | MD
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Telephone | 714-456-2986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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