| Organization Name: | RIVERBANK PRIMARY CARE MEDICAL CLINIC INC. |
| NPI Number: | 1043372618 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN PATRICK ERRO (ADMINISTRATOR) |
| Mailing Address: | 3227 Stanislaus St. Ste 'a' Riverbank |
| State: | CA US |
| Postal Code: | 95367 |
| Phone Number: | 2098690131 |
| Fax Number: | 2098695409 |
| NPI Enumeration Date: | 12/13/2006 |
| NPI Last Update Date: | 04/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | RHM53859F |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |