Healthcare Provider Details

I. General information

NPI: 1861923492
Provider Name (Legal Business Name): GLADYS VALDEZ RIVERA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82013 DR CARREON BLVD STE M
INDIO CA
92201-5832
US

IV. Provider business mailing address

PO BOX 2244
MECCA CA
92254-2244
US

V. Phone/Fax

Practice location:
  • Phone: 760-262-0233
  • Fax:
Mailing address:
  • Phone: 951-496-7814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA166374
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: