Healthcare Provider Details

I. General information

NPI: 1518400449
Provider Name (Legal Business Name): RILEY BELL RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RILEY BELL BT

II. Dates (important events)

Enumeration Date: 11/25/2016
Last Update Date: 11/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11037 WARNER AVE #339
FOUNTAIN VALLEY CA
92708-4007
US

IV. Provider business mailing address

11037 WARNER AVE #339
FOUNTAIN VALLEY CA
92708-4007
US

V. Phone/Fax

Practice location:
  • Phone: 800-273-4292
  • Fax: 949-253-4627
Mailing address:
  • Phone: 800-273-4292
  • Fax: 949-253-4627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberRBT-15-10627
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: