Organization
DELARIVA MD PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN DE LA RIVA (PRESIDENT)
(916) 778-6311
Entity
Organization
Contact information
Practice address
3477 CASTLE CREEK CT, ROSEVILLE, CA 95661-7354
(916) 778-6311
Mailing address
PO BOX 441, SUISUN CITY, CA 94585-0441
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207LP3000X
Pediatric Anesthesiology Physician
—
—
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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