Healthcare Provider Details

I. General information

NPI: 1013887892
Provider Name (Legal Business Name): RIVIERA PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 MESQUITE AVE STE B
LAKE HAVASU CITY AZ
86403-5771
US

IV. Provider business mailing address

1840 MESQUITE AVE STE B
LAKE HAVASU CITY AZ
86403-5771
US

V. Phone/Fax

Practice location:
  • Phone: 928-846-7097
  • Fax: 866-703-1213
Mailing address:
  • Phone: 928-846-7097
  • Fax: 866-703-1213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDRES ALVARADO
Title or Position: OWNER
Credential: MD
Phone: 928-846-7097