RIVERSIDE MEDICAL CLINIC, INC
NPI 1013561810
Family Medicine in Corona, CA
NPI Status: Active since July 30, 2019
Contact Information
21634 RETREAT PKWY
CORONA, CA
ZIP 92883
Phone: (951) 683-6370
- Organization
- Family Medicine
- CLIA Number: 05D1087354
- CLIA Cert. Type: Ancillary Testing Site in Health Care Center
- CLIA Exp. Date: 07-31-2026
About RIVERSIDE MEDICAL CLINIC, INC
This page provides the complete NPI Profile along with additional information for Riverside Medical Clinic, Inc, a primary care provider established in Corona, California operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1013561810 assigned on July 2019. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated June 2025. Riverside Medical Clinic, Inc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's
- NPI
- 1013561810
- Provider Legal Name
- RIVERSIDE MEDICAL CLINIC, INC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 21634 RETREAT PKWY CORONA, CA 92883
- Location Phone
- (951) 683-6370
- Mailing Address
- 3660 ARLINGTON AVE RIVERSIDE, CA 92506
- Mailing Phone
- (951) 683-6370
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-30-2019
- Last Update Date
- 06-10-2025
- Code Navigator
A primary care provider (PCP) like Riverside Medical Clinic, Inc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 21634 Retreat Pkwy
Corona, CA 92883
(951) 782-5157
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | |
| 2 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 3 | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 4 | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 5 | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 6 | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 7 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | |
| 8 | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | |
| 9 | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | |
| 10 | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | |
| 11 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | |
| 12 | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | |
| 13 | 208800000X | Allopathic & Osteopathic Physicians | Urology | |
| 14 | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D1087354
- Facility Type
- Ancillary Testing Site in Health Care Center
- Certificate Effective Date
- August 01, 2024
- Certificate Expiration Date
- July 31, 2026
- Laboratory Director
- STEVEN M. DETERVILLE MD
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Riverside Medical Clinic, Inc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
Reviews for RIVERSIDE MEDICAL CLINIC, INC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 1 | 3 | 5 | 6 | 1 | 8 | 1 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 2 | 3 | 10 | 6 | 2 | 8 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 2 + 3 + 1 + 0 + 6 + 2 + 8 + 2 + 24 = 50 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1013561810 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1518942804 | NAVID PARVIZ FURUTAN MD Individual | Pediatrics | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6830 |
| 1104939529 | DR. MARIO S FICAROLA M.D. Individual | Internal Medicine | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6926 |
| 1023200409 | DR. MASSIMO ARCERITO MD Individual | Surgery | 21634 RETREAT PKWY CORONA, CA 92883 (951) 278-8870 |
| 1609257435 | DR. POYRUNG POYSOPHON MD Individual | Family Medicine (Sports Medicine) | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6832 |
| 1881957686 | DR. KATRINA DIANN STINSON M.D. Individual | Obstetrics & Gynecology | 21634 RETREAT PKWY TEMESCAL VALLEY, CA 92883 (951) 493-8134 |
| 1598184244 | DEREK Q PHAN MD Individual | Internal Medicine (Cardiovascular Disease) | 21634 RETREAT PKWY TEMESCAL VALLEY, CA 92883 (951) 493-6650 |
| 1982879169 | DR. KAMESIAU DAMARA PREMMER M.D Individual | Anesthesiology | 21634 RETREAT PKWY CORONA, CA 92883 (951) 278-6050 |
| 1760043426 | RMC SURGERY CENTER LLC Organization | Clinic/Center (Ambulatory Surgical) | 21634 RETREAT PKWY CORONA, CA 92883 (951) 683-6370 |
| 1235307141 | ENNIS ZAITOON M.D. Individual | Internal Medicine | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6870 |
| 1053393959 | MOHAMMAD KHALED SHAHIN MD Individual | Internal Medicine | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6805 |
| 1063731297 | KIMBERLY TUSTISON MD Individual | Obstetrics & Gynecology | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6814 |
| 1164783908 | DR. SIMRAN BRAR DO Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6862 |
| 1184088841 | DR. MARIO FLORES D.O. Individual | Anesthesiology (Pain Medicine) | 21634 RETREAT PKWY TEMESCAL VALLEY, CA 92883 (951) 683-6370 |
| 1285670240 | DR. ADAM AHMED ZUBER M.D. Individual | Psychiatry & Neurology (Neurology) | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6927 |
| 1700860285 | STEVEN MICHAEL DETERVILLE MD Individual | Pediatrics | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6810 |
| 1801172291 | RONALD B CRATER M.D. Individual | Orthopaedic Surgery | 21634 RETREAT PKWY TEMESCAL VALLEY, CA 92883 (951) 493-6918 |
| 1851719512 | SAMARJEET BAJWA Individual | Psychiatry & Neurology (Neurology) | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6927 |
| 1881056489 | HAIDY ADEL TAWFIK YOUSSEF M.D. Individual | Internal Medicine (Rheumatology) | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6945 |
| 1881790418 | DR. ANAND RAJA BHUPATHY D.O. Individual | Dermatology | 21634 RETREAT PKWY CORONA, CA 92883 (951) 782-3818 |
| 1922081843 | RYAN FISHER RICKS DPM Individual | Podiatrist | 21634 RETREAT PKWY CORONA, CA 92883 (951) 493-6915 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1013561810, enumerated in the NPI registry as an "organization" on July 30, 2019
The provider is located at 21634 Retreat Pkwy Corona, Ca 92883 and the phone number is (951) 683-6370
This medical organization specializes in Family Medicine with taxonomy code 207Q00000X
The provider's CLIA number is 05D1087354 for a "ancillary testing site in health care center" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on July 30, 2019. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.