Provider Demographics
NPI:1639854581
Name:RIVERSIDE COMMUNITY COLLEGE DISTRICT
Entity Type:Organization
Organization Name:RIVERSIDE COMMUNITY COLLEGE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, MORENO VALLEY COLLEGE
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEINBACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-571-6160
Mailing Address - Street 1:16130 LASSALLE STREET
Mailing Address - Street 2:PSC-6
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92551
Mailing Address - Country:US
Mailing Address - Phone:951-571-6103
Mailing Address - Fax:951-571-8266
Practice Address - Street 1:16130 LASSALLE STREET
Practice Address - Street 2:PSC-6
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92551
Practice Address - Country:US
Practice Address - Phone:951-571-6103
Practice Address - Fax:951-571-8266
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVERSIDE COMMUNITY COLLEGE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health