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Organization
RIVERSIDE PLASTIC SURGERY ASSOCIATES INC.
Active
Organization
RIVERSIDE PLASTIC SURGERY ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN J. CHILDERS M.D. (PRESIDENT CFO)
(951) 781-4339
Entity
Organization
Contact information
Practice address
4605 BROCKTON AVE, SUITE 200, RIVERSIDE, CA 92506-0106
(951) 781-4339
(951) 274-0985
Mailing address
4605 BROCKTON AVE, SUITE 200, RIVERSIDE, CA 92506-0106
(951) 781-4339
(951) 274-0985
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G76953
CA
Other
Enumeration date
11/16/2006
Last updated
09/09/2009
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