Organization
RIVIERA SURGICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK DIEP (ADMINISTRATOR)
(928) 505-7246
Entity
Organization
Contact information
Practice address
3003 AZ-95, #63, BULLHEAD CITY, AZ 86442
(909) 994-5105
Mailing address
3003 AZ-95, #63, BULLHEAD CITY, AZ 86442
(928) 483-4566
(928) 483-4566
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/23/2021
Last updated
12/17/2025
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