Individual
DR. RICHARD DOMINIC PESAVENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9041 MAGNOLIA AVE, SUITE 207, RIVERSIDE, CA 92503-3900
(951) 788-0222
(951) 784-2696
Mailing address
9041 MAGNOLIA AVE, SUITE 207, RIVERSIDE, CA 92503-3900
(951) 788-0222
(951) 784-2696
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G44858
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G448580
—
CA
Enumeration date
12/19/2005
Last updated
05/27/2011
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