Individual
ANTONIO RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 INDIAN HILL ROAD, WINTERHAVEN, CA 92283
(760) 572-4115
(760) 572-2133
Mailing address
PO BOX 42532, TUCSON, AZ 85733-2532
(928) 919-2815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301079091
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
733255
—
AZ
Enumeration date
05/11/2006
Last updated
03/21/2025
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