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Organization

PLATINUM PROVIDERS MEDICAL GROUP INC

Active
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Organization

PLATINUM PROVIDERS MEDICAL GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT G NELSON MD (PRESIDENT)
(951) 737-8141
Entity
Organization

Contact information

Practice address
6900 BROCKTON AVE STE 100, RIVERSIDE, CA 92506-3817
(951) 781-3800
(951) 781-1973
Mailing address
2250 S MAIN ST STE 209, CORONA, CA 92882-2507
(951) 781-3800

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—

Other

Enumeration date
09/25/2018
Last updated
03/20/2026
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