| Ironstone Medical Clinic Inc | |
|
4121 Brockton Ave Ste 104 Riverside CA 92501-3442 | |
| (949) 355-4224 | |
| (951) 778-0051 |
| Full Name | Ironstone Medical Clinic Inc |
|---|---|
| Speciality | General Practice |
| Location | 4121 Brockton Ave Ste 104, Riverside, California |
| Authorized Official Name and Position | Sean Ataee (C.F.O.) |
| Authorized Official Contact | 9493554226 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ironstone Medical Clinic Inc 4121 Brockton Ave Ste 104 Riverside CA 92501-3442 Ph: (949) 355-4224 | Ironstone Medical Clinic Inc 4121 Brockton Ave Ste 104 Riverside CA 92501-3442 Ph: (949) 355-4224 |
| NPI Number | 1851587448 |
|---|---|
| Provider Enumeration Date | 09/18/2007 |
| Last Update Date | 10/03/2011 |
| Medicare PECOS PAC ID | 1456414002 |
|---|---|
| Medicare Enrollment ID | O20090108000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851587448 | NPI | - | NPPES |
| Provider Name | Errajith De Silva |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1083712236 PECOS PAC ID: 9335110501 Enrollment ID: I20040807000265 |
| Provider Name | Balraj Singh Khehra |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1821143264 PECOS PAC ID: 2961507322 Enrollment ID: I20070413000515 |
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