Provider Demographics
NPI:1295419182
Name:ENDOCRINE ASSOCIATES OF RIVERSIDE A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ENDOCRINE ASSOCIATES OF RIVERSIDE A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FREDDIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:DIAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-353-2769
Mailing Address - Street 1:3975 JACKSON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3947
Mailing Address - Country:US
Mailing Address - Phone:951-353-2769
Mailing Address - Fax:951-353-2779
Practice Address - Street 1:3975 JACKSON ST STE 200
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3947
Practice Address - Country:US
Practice Address - Phone:951-353-2769
Practice Address - Fax:951-353-2779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty