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General NPI Number Information
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NPI Number | 1245536333
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Entity Type | Individual
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Provider Name | JUAN ANTONIO RIOJAS PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 02/07/2011
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Last Update Date | 03/30/2017
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Provider Practice Location Address
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Address Line | 11870 SANTA MONICA BLVD 201
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City | LOS ANGELES
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State | CA
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Zip | 90025-2276
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Country | US
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Telephone | 310-979-8378
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Fax |
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Provider Business Mailing Address
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Address Line | 1141 N BRAND BLVD STE 302
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City | GLENDALE
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State | CA
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Zip | 91202-2511
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Country | US
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Telephone | 818-549-0977
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Fax | 818-450-0950
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA21429
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License Number State | CA
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