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Individual

MR. BENITO RIVAS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
12686 AVENUE 416, OROSI, CA 93647-2054
(559) 528-4717
(559) 528-0302
Mailing address
12683 AVENUE 416, OROSI, CA 93647-2017
(559) 528-4717
(559) 528-0302

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA15862
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA15862
PHYSICIAN ASSISTANT BOARD
CA
Enumeration date
01/30/2006
Last updated
11/28/2019
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