Individual
DR. JASON ISAIAH RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12631 E 17TH AVE STE F496, AURORA, CO 80045-2527
(720) 553-2696
Mailing address
12631 E 17TH AVE STE F496, AURORA, CO 80045-2527
(720) 553-2696
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
DR.0069518
CO
208D00000X
General Practice Physician
DR.0069518
CO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TL.0008534
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029486
KAISER COMMERCIAL NUMBER
CO
Enumeration date
04/21/2021
Last updated
08/18/2023
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