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Organization
RIVERSIDE FACULTY MEDICAL GROUP INC
Active
Organization
RIVERSIDE FACULTY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL KIM M.D. (MD/PRESIDENT)
(951) 486-5701
Entity
Organization
Contact information
Practice address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(951) 486-5700
(951) 486-5705
Mailing address
PO BOX 7270, MORENO VALLEY, CA 92552-7270
(951) 486-5700
(951) 486-5705
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0061940
—
CA
Enumeration date
07/29/2006
Last updated
03/20/2013
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