| Katrina Platt Do Pc | |
|
2388 Grace St Riverside CA 92504-4909 | |
| (909) 641-6708 | |
| Not Available |
| Full Name | Katrina Platt Do Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2388 Grace St, Riverside, California |
| Authorized Official Name and Position | Katrina Platt (PRESIDENT) |
| Authorized Official Contact | 9096416708 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katrina Platt Do Pc 5 E Citrus Ave Suite 209 Redlands CA 92373-4736 Ph: (909) 307-6007 | Katrina Platt Do Pc 2388 Grace St Riverside CA 92504-4909 Ph: (909) 641-6708 |
| NPI Number | 1740625607 |
|---|---|
| Provider Enumeration Date | 05/06/2013 |
| Last Update Date | 08/26/2013 |
| Medicare PECOS PAC ID | 7214166701 |
|---|---|
| Medicare Enrollment ID | O20140203001114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740625607 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 20A10988 (California) | Primary |
| Provider Name | Katrina Jane Platt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871749556 PECOS PAC ID: 4183754278 Enrollment ID: I20100616000753 |
| Provider Name | Stacey Pollom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306379631 PECOS PAC ID: 8123394913 Enrollment ID: I20171023002400 |
| Provider Name | Randi Celeste Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093208316 PECOS PAC ID: 5092056481 Enrollment ID: I20190412000166 |
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