Individual
RHETT BARRY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6405 DAY ST, RIVERSIDE, CA 92507-0901
(951) 697-5570
(951) 697-5596
Mailing address
3660 ARLINGTON AVE, RIVERSIDE, CA 92506-3912
(951) 697-5570
(951) 697-5596
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G19117
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730180415
GROUP NPI
CA
01
—
1780782557
SITE NPI
AZ
01
—
ZZZ31887Z
GROUP SITE NUMBER
—
01
—
ZZZ92058Z
OFFICE SITE #
CA
Enumeration date
11/23/2005
Last updated
03/17/2009
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