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NPI Code Detail

MEDICARE: PATRICIA J RIVERA

MEDICARE: PATRICIA J RIVERA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1114420205
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA J RIVERA
Provider Business Mailing Address
First Line : 1200 WILSHIRE BLVD STE 200
Second Line :
City : LOS ANGELES
State : CA
Zip : 90017-1930
Country : US
Telephone Number : 213-481-7464
Fax Number : 213-481-7147
Provider Business Practice Location Address
First Line : 5603 S CENTRAL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-5967
Country : US
Telephone Number : 323-812-5267
Fax Number : 213-481-7147
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2018
Last Update Date : 01/06/2025

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Directions to “ PATRICIA J RIVERA ” Practice Location

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