Organization
RIVERSIDE RADIOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY KERKAR (CEO)
(951) 781-2270
Entity
Organization
Contact information
Practice address
12276 HESPERIA RD, STE 6, VICTORVILLE, CA 92395-5838
(760) 843-0995
(760) 843-0975
Mailing address
PO BOX 52499, RIVERSIDE, CA 92517-3499
(951) 781-2270
(951) 787-6628
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG9918
NONE
CA
05
—
ZZZ751532
—
CA
Enumeration date
08/02/2005
Last updated
07/21/2022
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