Individual
MRS. ELIZABETH RIVERA REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 W BASTANCHURY RD STE 115, FULLERTON, CA 92835-3423
(714) 446-9030
(714) 446-9130
Mailing address
301 W BASTANCHURY RD STE 115, FULLERTON, CA 92835-3423
(714) 446-9030
(714) 446-9130
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A67305
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8688134
—
CA
05
—
9668134
—
CA
Enumeration date
09/20/2006
Last updated
04/18/2012
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