Organization
RIVERSIDE RADIOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD RAY MASSEE M.D. (PRESIDENT)
(559) 455-4065
Entity
Organization
Contact information
Practice address
400 WARREN DR, APT. 4, SAN FRANCISCO, CA 94131-1075
(559) 455-4065
(770) 666-9102
Mailing address
1660 CHICAGO AVE, M-9, RIVERSIDE, CA 92507-2068
(559) 455-4065
(770) 666-9102
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A112768
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194979856
—
CA
Enumeration date
07/20/2015
Last updated
07/20/2015
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