Organization
ALTAIS MEDICAL GROUP - RIVERSIDE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICIO EDUARDO BUENO (DIRECTOR/PRESIDENT)
(323) 791-0557
Entity
Organization
Contact information
Practice address
4646 BROCKTON AVE STE 201, RIVERSIDE, CA 92506-0104
(626) 840-1359
Mailing address
4646 BROCKTON AVE STE 201, RIVERSIDE, CA 92506-0104
(951) 585-1800
(951) 585-1801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/07/2021
Last updated
03/31/2026
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