Individual
JUAN C DE LA RIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 W FERN AVE, REDLANDS, CA 92373
(909) 786-0725
Mailing address
PO BOX 10069, SAN BERNARDINO, CA 92423-0069
(916) 749-3510
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G58822
CA
Other
Enumeration date
05/31/2006
Last updated
02/25/2019
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