Provider Demographics
NPI:1841023801
Name:JAVIER R. RIOS MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:JAVIER R. RIOS MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:R
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-354-3221
Mailing Address - Street 1:495 E RINCON ST STE 215
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1378
Mailing Address - Country:US
Mailing Address - Phone:951-523-0117
Mailing Address - Fax:
Practice Address - Street 1:4022 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-5340
Practice Address - Country:US
Practice Address - Phone:855-505-7467
Practice Address - Fax:888-975-8926
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAVIER R. RIOS A PROFESSIONAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty