| Spore Society Llc | |
|
4445 Magnolia Ave Riverside CA 92501-4135 | |
| (786) 929-8596 | |
| Not Available |
| Full Name | Spore Society Llc |
|---|---|
| Speciality | Clinic/center - Corporate Health |
| Location | 4445 Magnolia Ave, Riverside, California |
| Authorized Official Name and Position | Aiyon Saiid Peoples-neal (CEO) |
| Authorized Official Contact | 7869298596 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spore Society Llc 4445 Magnolia Ave Riverside CA 92501-4135 Ph: (786) 929-8596 | Spore Society Llc 4445 Magnolia Ave Riverside CA 92501-4135 Ph: (786) 929-8596 |
| NPI Number | 1497543029 |
|---|---|
| Provider Enumeration Date | 04/25/2025 |
| Last Update Date | 04/25/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497543029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QC1800X | Clinic/center - Corporate Health | (* (Not Available)) | Primary |
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