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GRACE MEDICAL SPA
NPI 1689357030
Internal Medicine in Riverside, CA

Active since August 11, 2023CLIA 05D2298512 · Waiver
6900 BROCKTON AVE STE 200, RIVERSIDE, CA 92506(909) 664-4634 Get Directions Write a Review

NPPES record last updated: December 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 8, 2023, Oct 31, 2023, Aug 11, 2023 (3 updates tracked since 2023).

About Grace Medical Spa NPPES

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

GRACE MEDICAL SPA (NPI 1689357030) is a healthcare organization registered as an internal medicine in Riverside, California and active in the NPI registry since August 2023. The organization holds a CLIA Waiver certificate valid through February 1, 2028 and lists Phillip Alhir, Coo, as its authorized official.

NPPES Registry Identity

NPI1689357030
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameGRACE MEDICAL AND WELLNESS CLINIC
Location Address6900 BROCKTON AVE STE 200Riverside, CA 92506-3818
Mailing Address6900 Brockton Ave Ste 200Riverside, CA 92506-3818 · (909) 664-4634
Phone(909) 664-4634
Organization SubpartNo
Authorized OfficialPhillip AlhirCoo · (909) 664-4634
Enumeration DateAugust 11, 2023
Last NPPES UpdateDecember 8, 20233 updates tracked since enumeration
NPPES CertifiedDecember 8, 2023
✔ NPI 1689357030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
6900 BROCKTON AVE STE 200, Riverside, CA 92506
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Other Names 1

Doing Business AsGrace Medical Spa

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 05D2298512

Grace Medical And Wellness Clinic · Riverside, CA
Active · expires Feb 1, 2028
CLIA Number05D2298512
Laboratory TypePhysician Office
Certificate Effective DateFebruary 2, 2026
Certificate Expiration DateFebruary 1, 2028
Laboratory DirectorMousa Matar
Laboratory Phone(951) 682-6263
Laboratory LocationGrace Medical And Wellness Clinic6900 Brockton Ave, #200, Riverside, CA 92506
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

SAMER S SANNOUFI MD
Family Medicine
6900 BROCKTON AVE STE 200
RIVERSIDE, CA 92506
Riverside County (951) 682-6263
RUTH RAMIREZ NP
Nurse Practitioner (Family)
6900 BROCKTON AVE STE 200
RIVERSIDE, CA 92506
Riverside County (951) 682-6263
PRIMARY CARE FAMILY PRACTICE APC
Family Medicine
6900 BROCKTON AVE STE 200
RIVERSIDE, CA 92506
Riverside County (951) 682-6263
EUNJIN LEE
Nurse Practitioner (Primary Care)
6900 BROCKTON AVE STE 200
RIVERSIDE, CA 92506
Riverside County (951) 682-6263

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 Grace Medical And Wellness Clinic's NPI number?

The NPI number for Grace Medical And Wellness Clinic is 1689357030. It was assigned to this organization in the NPPES registry on August 11, 2023. The provider is doing business as Grace Medical Spa.

Where is Grace Medical And Wellness Clinic located?

Grace Medical And Wellness Clinic is located at 6900 Brockton Ave Ste 200, Riverside, CA 92506. The listed phone number is (909) 664-4634.

What is Grace Medical And Wellness Clinic's specialty?

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

Does Grace Medical And Wellness Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2298512) is associated with this NPI, valid through February 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grace Medical And Wellness Clinic was last updated on December 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.