| Kenneth M Dale, DO | |
|
4445 Magnolia Ave, Riverside, CA 92501 | |
| (951) 788-3000 | |
| Not Available |
| Full Name | Kenneth M Dale |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 4445 Magnolia Ave, Riverside, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932158771 | NPI | - | NPPES |
| 772485 | Medicaid | AZ | |
| 00AX70600 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 3838 (Arizona) | Primary |
| Entity Name | Cep America - California |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023063542 PECOS PAC ID: 6103739131 Enrollment ID: O20031106000520 |
| Entity Name | Lakeside Medical Organization A Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831426642 PECOS PAC ID: 7618005166 Enrollment ID: O20100505000015 |
| Entity Name | Western Sierra Emergency Physicians Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881995272 PECOS PAC ID: 6709069396 Enrollment ID: O20110318000559 |
| Entity Name | Elite Hospitalist Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639598758 PECOS PAC ID: 9638394455 Enrollment ID: O20141020002313 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth M Dale, DO 2100 Powell St, Ste 920, Emeryville, CA 94608-1803 Ph: (510) 350-2600 | Kenneth M Dale, DO 4445 Magnolia Ave, Riverside, CA 92501 Ph: (951) 788-3000 |
Rushil Anil Patel, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 4445 Magnolia Ave, Riverside, CA 92501 Phone: 951-788-3000 | |
Dr. Chad Leroy Clark, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3865 Jackson St, Riverside, CA 92503 Phone: 951-352-5666 Fax: 951-352-5445 | |
Dr. David Stuart Siegel, MD Emergency Medicine Medicare: May Accept Medicare Assignments Practice Location: 3425 Torrey St, Riverside, CA 92503 Phone: 561-685-6148 | |
Doug John Williamson, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 10800 Magnolia Ave, Riverside, CA 92505 Phone: 909-353-2000 | |
Kenneth Johnson, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 4445 Magnolia Ave, Riverside, CA 92501 Phone: 951-788-3537 Fax: 951-788-3173 | |
Ashwin Rohan Sharma, Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 4445 Magnolia Ave, Riverside, CA 92501 Phone: 951-205-3340 | |
Dr. Ernest Woodhouse, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 4440 Magnolia Ave., Riverside, CA 92501 Phone: 951-788-3200 |