# PETER P. KIM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverside Medical Supply, Co.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164538369
- **Authorized official:** MR. PETER P KIM RN (OWNER)
- **Authorized official phone:** (951) 343-0428

## Contact information

- **Practice address:** 10280 INDIANA AVE, RIVERSIDE, CA 92503-5357
- **Practice address phone:** (951) 343-0428
- **Practice address fax:** (951) 343-0438
- **Mailing address:** 10280 INDIANA AVE, RIVERSIDE, CA 92503-5357
- **Mailing address phone:** (951) 343-0428
- **Mailing address fax:** (951) 343-0438

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 44384 | CA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 01/26/2011