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6485 Day St Ste 305, Riverside, CA 92507-0926 | |
(951) 413-6433 | |
(951) 413-6633 |
Full Name | |
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Type | Facility |
Speciality | Pain Medicine - Interventional Pain Medicine |
Location | 6485 Day St Ste 305, Riverside, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1154412963 | NPI | - | NPPES |
Provider Name | Augusta U Ikhisemojie |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1457389041 PECOS PAC ID: 3173590742 Enrollment ID: I20040913001363 |
Mailing Address | Practice Location Address |
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Po Box 60790, Pasadena, CA 91116-6790 Ph: (626) 795-6596 | 6485 Day St Ste 305, Riverside, CA 92507-0926 Ph: (951) 413-6433 |