MEDICARE: PROVIDENCE AMBULATORY SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician

General Provider Information

NPI Number	:	1710694161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROVIDENCE AMBULATORY SERVICES INC

Provider Business Mailing Address
First Line	:	3975 JACKSON ST STE 105
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92503-3945
Country	:	US
Telephone Number	:	951-775-2407
Fax Number	:

Provider Business Practice Location Address
First Line	:	3975 JACKSON ST STE 105
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92503-3945
Country	:	US
Telephone Number	:	951-775-2407
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NAWAL BADRAN
Credential	:	MD
Telephone Number	:	951-775-2407

Provider Enumeration Date	:	11/03/2022
Last Update Date	:	11/03/2022

Similar Medicare Providers

1841345162 — ANAND PRAKASH, M.D., INC.
Practice Location Address:

3975 JACKSON STREET , SUITE #105
RIVERSIDE, CA
92503-3945

Practice Phone: 951-359-6030
Practice Fax: 951-359-6032

1629363445 — MR. RICHARD A. ROWE LCSW
Practice Location Address:

3576 ARLINGTON AVE STE 200
RIVERSIDE, CA
92506-3945

Practice Phone: 951-836-0419
Practice Fax:

1346091378 — YUMI KWON
Practice Location Address:

3576 ARLINGTON AVE STE 200
RIVERSIDE, CA
92506-3945

Practice Phone: 818-635-8704
Practice Fax:

1336961440 — EILENE ROSETE ACSW
Practice Location Address:

3576 ARLINGTON AVE STE 200
RIVERSIDE, CA
92506-3945

Practice Phone: 951-836-0419
Practice Fax:

1871445361 — MRS. MICHELLE JOLENE KRIEGE MFT, LVN
Practice Location Address:

3576 ARLINGTON AVE STE 200
RIVERSIDE, CA
92506-3945

Practice Phone: 951-836-0419
Practice Fax:

1982520292 — PAMELA DORSE LVN
Practice Location Address:

3933 HARRISON ST
RIVERSIDE, CA
92503-3523

Practice Phone: 833-391-0505
Practice Fax: 951-476-4342

Directions to “PROVIDENCE AMBULATORY SERVICES INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.