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RIVERSIDE MEDICAL CLINIC, INC
NPI 1013561810
Family Medicine in Corona, CA

Active since July 30, 2019CLIA Certified · 3 labs
21634 RETREAT PKWY, CORONA, CA 92883(951) 683-6370 Get Directions Write a Review

NPPES record last updated: June 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 10, 2025, Jul 30, 2019 (2 updates tracked since 2019).

About Riverside Medical Clinic, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RIVERSIDE MEDICAL CLINIC, INC (NPI 1013561810), doing business as Riverside Medical Clinic, is a healthcare organization registered as a family medicine in Corona, California and active in the NPI registry since July 2019. The organization holds 3 active CLIA laboratory certificates, maintains a secondary practice location in Corona, and lists Anupam Gupta, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1013561810
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameRIVERSIDE MEDICAL CLINIC, INC
Location Address21634 RETREAT PKWYCorona, CA 92883-6100
Mailing Address3660 Arlington AveRiverside, CA 92506-3987 · (951) 683-6370 · Fax (951) 248-6708
Phone(951) 683-6370
Organization SubpartNo
Authorized OfficialAnupam GuptaMedical Director · (951) 683-6370
Enumeration DateJuly 30, 2019
Last NPPES UpdateJune 10, 20252 updates tracked since enumeration
NPPES CertifiedJune 10, 2025
✔ NPI 1013561810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedAnesthesiology · Pain MedicineTaxonomy 207LP2900X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X
Also ListedInternal Medicine · RheumatologyTaxonomy 207RR0500X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedOphthalmologyTaxonomy 207W00000X
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
Also ListedOtolaryngologyTaxonomy 207Y00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X
Also ListedUrologyTaxonomy 208800000X
Also ListedPodiatristTaxonomy 213E00000X
21634 RETREAT PKWY, Corona, CA 92883
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Other Names 1

Doing Business AsRiverside Medical Clinic

Secondary Practice Location 1

Location 121634 Retreat PkwyCorona, CA 92883-6100 · Phone (951) 782-5157

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0911851

Riverside Medical Clinic · Riverside, CA
Active · expires Feb 14, 2028
CLIA Number05D0911851
Laboratory TypePhysician Office
Certificate Effective DateFebruary 15, 2026
Certificate Expiration DateFebruary 14, 2028
Laboratory DirectorThuan D. Le
Laboratory Phone(909) 683-6370
Laboratory LocationRiverside Medical Clinic7160 Brockton Avenue 2nd Floor, Riverside, CA 92506
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0911853

Riverside Medical Clinic Inc · Riverside, CA
Active · expires Feb 3, 2028
CLIA Number05D0911853
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateFebruary 4, 2026
Certificate Expiration DateFebruary 3, 2028
Laboratory DirectorTony Kwon MD
Laboratory Phone(951) 321-6307
Laboratory LocationRiverside Medical Clinic Inc7117 Brockton Ave, Riverside, CA 92506
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D2058289

Riverside Medical Clinic, Inc · Corona, CA
Active · expires May 2, 2027
CLIA Number05D2058289
Laboratory TypePhysician Office
Certificate Effective DateMay 3, 2025
Certificate Expiration DateMay 2, 2027
Laboratory DirectorTony S. Kwon MD
Laboratory Phone(951) 321-6307
Laboratory LocationRiverside Medical Clinic, Inc12742 Limonite Ave, Corona, CA 92882
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D1087354

Riverside Medical Clinic Inc · Corona, CA
Expired · Jul 31, 2026
CLIA Number05D1087354
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateAugust 1, 2024
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorSteven M. Deterville MD
Laboratory Phone(951) 321-6307
Laboratory LocationRiverside Medical Clinic Inc21634 Retreat Parkway, Corona, CA 92883
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MASSIMO ARCERITO MD
Surgery
21634 RETREAT PKWY
CORONA, CA 92883
Riverside County (951) 278-8870
DR. MISBAH PATEL RASOOL M.D.
Family Medicine
21634 RETREAT PKWY
CORONA, CA 92883
Riverside County (951) 493-6835
MOHAMMAD KHALED SHAHIN MD
Internal Medicine
21634 RETREAT PKWY
CORONA, CA 92883
Riverside County (951) 493-6805
ALEXANDER JAMES GEYER M.D.
Family Medicine
21634 RETREAT PKWY
CORONA, CA 92883
Riverside County (951) 493-6921
JACQUELYN V LACERA MD
Family Medicine
21634 RETREAT PKWY
CORONA, CA 92883
Riverside County (951) 493-6906
KIMBERLY TUSTISON MD
Obstetrics & Gynecology
21634 RETREAT PKWY
CORONA, CA 92883
Riverside County (951) 493-6814
DR. MARIO S FICAROLA M.D.
Internal Medicine
21634 RETREAT PKWY
CORONA, CA 92883
Riverside County (951) 493-6926
MANDIRA MANOJ PATEL DO
Internal Medicine (Cardiovascular Disease)
21634 RETREAT PKWY
TEMESCAL VALLEY, CA 92883
Riverside County (951) 493-6905

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Riverside Medical Clinic, Inc's NPI number?

The NPI number for Riverside Medical Clinic, Inc is 1013561810. It was assigned to this organization in the NPPES registry on July 30, 2019. The provider is doing business as Riverside Medical Clinic.

Where is Riverside Medical Clinic, Inc located?

Riverside Medical Clinic, Inc is located at 21634 Retreat Pkwy, Corona, CA 92883. The listed phone number is (951) 683-6370.

What is Riverside Medical Clinic, Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Riverside Medical Clinic, Inc hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Riverside Medical Clinic, Inc was last updated on June 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.