Provider Demographics
NPI:1770855983
Name:EUGENE W. ALBRIGHT, M.D., INC.
Entity Type:Organization
Organization Name:EUGENE W. ALBRIGHT, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ALBRIGHT
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:951-781-7184
Mailing Address - Street 1:4000 14TH STREET,
Mailing Address - Street 2:SUITE #314
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-4018
Mailing Address - Country:US
Mailing Address - Phone:951-781-7140
Mailing Address - Fax:951-781-7184
Practice Address - Street 1:4000 14TH STREET
Practice Address - Street 2:SUITE #314
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-4018
Practice Address - Country:US
Practice Address - Phone:951-781-7184
Practice Address - Fax:951-781-7184
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EUGENE W. ALBRIGHT, M.D., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-02
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC40864207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1114983848Medicaid