Healthcare Provider Details

I. General information

NPI: 1568125334
Provider Name (Legal Business Name): RIVA HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 AURORA CT
AURORA CO
80045-2541
US

IV. Provider business mailing address

728 LEXINGTON WAY
BURLINGAME CA
94010-2750
US

V. Phone/Fax

Practice location:
  • Phone: 925-695-5094
  • Fax:
Mailing address:
  • Phone: 925-695-5094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: GLENN HIRSCH
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 925-695-5094