# RIVERSIDE PHYSICIAN SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RIVERSIDE PHYSICIAN SERVICES, INC
- **Other names:** Riverside Regional Anesthesiology
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790001501
- **Legal business name:** RIVERSIDE PHYSICIAN SERVICES, INC
- **Authorized official:** MR. TONY MINA (CEO)
- **Authorized official phone:** (757) 594-4006

## Contact information

- **Practice address:** 500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
- **Practice address phone:** (757) 594-2190
- **Practice address fax:** (757) 594-2195
- **Mailing address:** 856 J CLYDE MORRIS BLVD, STE A, NEWPORT NEWS, VA 23601-1318
- **Mailing address phone:** (757) 594-4006
- **Mailing address fax:** (757) 594-2195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/19/2010
- **Last updated:** 04/19/2010