| Blue Zones Health Centers Of California | |
|
4368 Central Ave Riverside CA 92506-2918 | |
| (909) 353-1610 | |
| Not Available |
| Full Name | Blue Zones Health Centers Of California |
|---|---|
| Speciality | Family Medicine |
| Location | 4368 Central Ave, Riverside, California |
| Authorized Official Name and Position | Wayne Stephen Dysinger (CEO) |
| Authorized Official Contact | 9517427324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Zones Health Centers Of California 4368 Central Ave Riverside CA 92506-2918 Ph: (951) 742-7324 | Blue Zones Health Centers Of California 4368 Central Ave Riverside CA 92506-2918 Ph: (909) 353-1610 |
| NPI Number | 1912395435 |
|---|---|
| Provider Enumeration Date | 01/06/2015 |
| Last Update Date | 08/08/2024 |
| Medicare PECOS PAC ID | 4385940972 |
|---|---|
| Medicare Enrollment ID | O20160308001246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912395435 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 2083P0901X | Preventive Medicine - Public Health & General Preventive Medicine | (* (Not Available)) | Secondary |
| Provider Name | Wayne Stephen Dysinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023121837 PECOS PAC ID: 1557251840 Enrollment ID: I20040318001769 |
| Provider Name | Dipika R Pandit |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194967653 PECOS PAC ID: 0042448300 Enrollment ID: I20140113000277 |
| Provider Name | Melinda J Steele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003040775 PECOS PAC ID: 2769631753 Enrollment ID: I20150106000059 |
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