Provider Demographics
NPI:1669880753
Name:COUNTY OF RIVERSIDE
Entity type:Organization
Organization Name:COUNTY OF RIVERSIDE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON-TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-358-5998
Mailing Address - Street 1:4065 COUNTY CIRCLE DR STE 403
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3410
Mailing Address - Country:US
Mailing Address - Phone:951-358-5222
Mailing Address - Fax:951-358-5292
Practice Address - Street 1:5256 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92509-4624
Practice Address - Country:US
Practice Address - Phone:951-955-0840
Practice Address - Fax:951-955-5317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental