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RAINCROSS MEDICAL CENTER OF DERMATOLOGY AND COSMETIC SURGERY INC NPI 1588612816


NPI Information

NPI: 1588612816
Provider Name: RAINCROSS MEDICAL CENTER OF DERMATOLOGY AND COSMETIC SURGERY, INC
Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

CLIA Number: 05D1003236

Address:
4336 MARKET ST
RIVERSIDE, CA
ZIP 92501
Phone: (951) 682-9293
Get Directions

RAINCROSS MEDICAL CENTER OF DERMATOLOGY AND COSMETIC SURGERY, INC is a procedural dermatology dermatology in Riverside, CA. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). RAINCROSS MEDICAL CENTER OF DERMATOLOGY AND COSMETIC SURGERY, INC NPI is 1588612816. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4336 MARKET ST
RIVERSIDE, CA
ZIP 92501-518
Phone: (951) 682-9293
Fax: (951) 682-9299

The provider's authorized official is Ethan Quan Nguyen .
The authorized official title is Medical Director and has the following contact phone number (951) 682-9293.

The CLIA number assigned to this NPI record is 05D1003236 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/5/2006 and was last updated on 8/1/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207NS0135XDermatologyProcedural DermatologyG77748CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERCALIFORNIATAX ID
2G72985MEDICARE UPINCALIFORNIA
3ZZZ31422ZMEDICARE PINCALIFORNIA
4P00017530OTHERCALIFORNIARAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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