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PLATINUM PROVIDERS MEDICAL GROUP INC
NPI 1275018392
Internal Medicine in Riverside, CA

Active since September 25, 2018CLIA 05D2159732 · Waiver
6900 BROCKTON AVE STE 100, RIVERSIDE, CA 92506(951) 781-3800(951) 781-1973 Get Directions Write a Review

NPPES record last updated: March 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 20, 2026, Nov 12, 2025, Aug 6, 2025 and 2 more (5 updates tracked since 2018).

About Platinum Providers Medical Group Inc NPPES

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

PLATINUM PROVIDERS MEDICAL GROUP INC (NPI 1275018392) is a healthcare organization registered as an internal medicine in Riverside, California and active in the NPI registry since September 2018. The organization holds a CLIA Waiver certificate valid through December 23, 2026 and lists Robert G Nelson, President, as its authorized official.

NPPES Registry Identity

NPI1275018392
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePLATINUM PROVIDERS MEDICAL GROUP INC
Location Address6900 BROCKTON AVE STE 100Riverside, CA 92506-3817
Mailing Address2250 S Main St Ste 209Corona, CA 92882-2507 · (951) 781-3800
Phone(951) 781-3800
Fax(951) 781-1973
Organization SubpartNo
Authorized OfficialRobert G NelsonPresident · (951) 737-8141
Enumeration DateSeptember 25, 2018
Last NPPES UpdateMarch 20, 20265 updates tracked since enumeration
NPPES CertifiedMarch 20, 2026
✔ NPI 1275018392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
6900 BROCKTON AVE STE 100, Riverside, CA 92506
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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

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 of Waiver 05D2159732

Platinum Providers Medical Group · Riverside, CA
Active · expires Dec 23, 2026
CLIA Number05D2159732
Laboratory TypePhysician Office
Certificate Effective DateDecember 24, 2024
Certificate Expiration DateDecember 23, 2026
Laboratory DirectorPeter N. Mattar
Laboratory Phone(951) 781-3800
Laboratory LocationPlatinum Providers Medical Group6900 Brockton Ave Suite 100, Riverside, CA 92506
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

JOHN GASPAR AGTUCA D.O.
Internal Medicine
6900 BROCKTON AVE STE 100
RIVERSIDE, CA 92506
Riverside County (951) 781-3800

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 Platinum Providers Medical Group Inc's NPI number?

The NPI number for Platinum Providers Medical Group Inc is 1275018392. It was assigned to this organization in the NPPES registry on September 25, 2018.

Where is Platinum Providers Medical Group Inc located?

Platinum Providers Medical Group Inc is located at 6900 Brockton Ave Ste 100, Riverside, CA 92506. The listed phone number is (951) 781-3800.

What is Platinum Providers Medical Group Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Platinum Providers Medical Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2159732) is associated with this NPI, valid through December 23, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Platinum Providers Medical Group Inc was last updated on March 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.