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Organization
PEDIATRIC MEDICAL GROUP OF RIVERSIDE INC.
Active
Organization
PEDIATRIC MEDICAL GROUP OF RIVERSIDE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBERTA CLARK (OFFICE MANAGER)
(951) 686-8223
Entity
Organization
Contact information
Practice address
6950 BROCKTON AVE, RIVERSIDE, CA 92506-3831
(951) 686-8223
(951) 686-9617
Mailing address
6950 BROCKTON AVE, RIVERSIDE, CA 92506-3831
(951) 686-8223
(951) 686-9617
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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