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NPI Code Detail

MEDICARE: COUNTY OF RIVERSIDE

MEDICARE: COUNTY OF RIVERSIDE
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
1251K00000XPublic Health or Welfare Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CCS00007FOTHERCAMEDI-CAL PROVIDER NUMBER

General Provider Information

NPI Number : 1922172709
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTY OF RIVERSIDE
Provider Business Mailing Address
First Line : PO BOX 7600
Second Line :
City : RIVERSIDE
State : CA
Zip : 92513-7600
Country : US
Telephone Number : 951-358-5401
Fax Number : 951-358-5150
Provider Business Practice Location Address
First Line : 1055 E VISTA CHINO
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92262-3207
Country : US
Telephone Number : 760-325-7549
Fax Number : 760-322-2944
Authorized Official
Title or Position : PHO - ADMIN PHYSICIAN III
Name : DR. GEOFFREY WON-CHEN LEUNG
Credential : MD
Telephone Number : 951-358-5121
Provider Enumeration Date : 11/20/2006
Last Update Date : 10/21/2024

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Directions to “COUNTY OF RIVERSIDE ” Practice Location

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