Organization
RAYMOND T. RIVERA, MD APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND T RIVERA M.D. (PRESIDENT)
(818) 345-9600
Entity
Organization
Contact information
Practice address
5525 ETIWANDA AVE, SUITE 222, TARZANA, CA 91356-3647
(818) 345-9600
Mailing address
PO BOX 507, WOODLAND HILLS, CA 91365-0507
(818) 345-9600
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G83979
CA
Other
Enumeration date
04/17/2007
Last updated
12/28/2007
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