Individual
DR. RAVI THIRUVENGADAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6950 BROCKTON AVE STE 3, RIVERSIDE, CA 92506-3830
(951) 788-7805
(951) 788-7906
Mailing address
6950 BROCKTON AVE STE 3, RIVERSIDE, CA 92506-3830
(951) 788-7805
(951) 788-7906
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A044566
CA
207RG0100X
Gastroenterology Physician
Primary
A044566
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A445661
—
CA
Enumeration date
08/30/2005
Last updated
07/11/2023
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