Individual
JANIERO MICHAEL RILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 S BARNWELL ST, OCEANSIDE, CA 92054-4507
(619) 246-0561
Mailing address
5236 GOLDEN LN APT B, LAS VEGAS, NV 89119-1845
(562) 758-5354
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2102065323
DRIVER LICENSE
NV
Enumeration date
12/09/2022
Last updated
12/09/2022
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