Organization
RIVERSIDE FAMILY PHYSICIANS
Active
Parent organization
MEDVANTX, INC.
Other names
Riverside Family Physicians - Orange
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (SR. DIRECTOR OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
4310 ORANGE ST, RIVERSIDE, CA 92501-3829
(951) 781-6335
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A53772
CA
Other
Enumeration date
09/20/2010
Last updated
10/23/2012
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