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General NPI Number Information
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NPI Number | 1063225761
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Entity Type | Individual
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Provider Name | EDUARDO RIVAS M.S., CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 3526 TWEEDY BLVD
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City | SOUTH GATE
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State | CA
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Zip | 90280-6026
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Country | US
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Telephone | 562-731-9599
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Fax |
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Provider Business Mailing Address
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Address Line | 10214 ORANGE AVE
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City | SOUTH GATE
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State | CA
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Zip | 90280-6914
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Country | US
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Telephone | 562-731-9599
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 26236
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License Number State | CA
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