Individual
ELIZABETH RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
316 E 25TH ST, LOS ANGELES, CA 90011-1406
(213) 271-5426
Mailing address
316 E 25TH ST, LOS ANGELES, CA 90011-1406
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RDA95015
—
CA
Enumeration date
07/08/2020
Last updated
07/08/2020
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