Scintadel Liberty, Inc. - Medicare Primary Care in Riverside, CA

Scintadel Liberty, Inc. is a medicare enrolled primary clinic (Psychiatry & Neurology - Psychiatry) in Riverside, California. The current practice location for Scintadel Liberty, Inc. is 6833 Indiana Ave Ste 208, Riverside, California. For appointments, you can reach them via phone at (213) 422-6853. The mailing address for Scintadel Liberty, Inc. is 921 N Milliken Ave # 1176, Ontario, California and phone number is (213) 422-6853.

Scintadel Liberty, Inc. is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1164122800. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (213) 422-6853.

Contact Information

Scintadel Liberty, Inc.
6833 Indiana Ave Ste 208
Riverside
CA 92506-4223
(213) 422-6853
Not Available

Primary Care Clinic Profile

Full NameScintadel Liberty, Inc.
SpecialityPsychiatry & Neurology
Location6833 Indiana Ave Ste 208, Riverside, California
Authorized Official Name and PositionVijay Chandran (CEO)
Authorized Official Contact2134226853
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Scintadel Liberty, Inc.
921 N Milliken Ave # 1176
Ontario
CA 91764-5083

Ph: (213) 422-6853
Scintadel Liberty, Inc.
6833 Indiana Ave Ste 208
Riverside
CA 92506-4223

Ph: (213) 422-6853

NPI Details:

NPI Number1164122800
Provider Enumeration Date03/09/2023
Last Update Date04/26/2023

Medicare PECOS Information:

Medicare PECOS PAC ID8820452139
Medicare Enrollment IDO20230919003100

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› Verified 8 days ago

Medical Identifiers

Medical identifiers for Scintadel Liberty, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164122800NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Secondary
2084P0800XPsychiatry & Neurology - Psychiatry (* (Not Available))Primary
2084P0802XPsychiatry & Neurology - Addiction Psychiatry (* (Not Available))Secondary
363L00000XNurse Practitioner (* (Not Available))Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Scintadel Liberty, Inc. acts as a billing entity for following providers:
Provider NameBuchi S Imoohi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811137938
PECOS PAC ID: 8123299567
Enrollment ID: I20110930000052

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Provider NameOluwatoyin Monsurat Ogunjale
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326605148
PECOS PAC ID: 9537535323
Enrollment ID: I20221019001978

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› Verified 8 days ago


Psychiatry & Neurology in Riverside, CA

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