Individual
CARLOS MARCIAL RIVERO-PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4550 W OAKEY BLVD STE 111-O, LAS VEGAS, NV 89102-1581
(702) 861-0238
Mailing address
4763 E HARMON AVE, LAS VEGAS, NV 89121-6921
(702) 906-9213
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821520016
—
NV
Enumeration date
10/14/2019
Last updated
10/14/2019
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