| Raincross Medical Group Inc | |
|
4646 Brockton Ave Riverside CA 92506-0102 | |
| (951) 774-2881 | |
| (951) 774-2846 |
| Full Name | Raincross Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4646 Brockton Ave, Riverside, California |
| Authorized Official Name and Position | Deborah Ann Novellino (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9517742881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Raincross Medical Group Inc 4646 Brockton Ave Riverside CA 92506-0102 Ph: (951) 774-2881 | Raincross Medical Group Inc 4646 Brockton Ave Riverside CA 92506-0102 Ph: (951) 774-2881 |
| NPI Number | 1194712315 |
|---|---|
| Provider Enumeration Date | 10/03/2005 |
| Last Update Date | 07/03/2013 |
| Medicare PECOS PAC ID | 9638079304 |
|---|---|
| Medicare Enrollment ID | O20040109000653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194712315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207Y00000X | Otolaryngology | (* (Not Available)) | Secondary |
| Provider Name | Carl Knopke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073500294 PECOS PAC ID: 9436121373 Enrollment ID: I20040810001502 |
| Provider Name | Betina G Gideon Greer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316924582 PECOS PAC ID: 1254350440 Enrollment ID: I20051116000992 |
| Provider Name | Yanjapriya Kunaseelan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962816694 PECOS PAC ID: 9234402397 Enrollment ID: I20170912001597 |
| Provider Name | Daniel Celeo Solis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619464161 PECOS PAC ID: 7517385115 Enrollment ID: I20200914002880 |
| Provider Name | Julian Kweku Esuon Hinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164049987 PECOS PAC ID: 7113463126 Enrollment ID: I20240726000907 |
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