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General NPI Number Information
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NPI Number | 1396232591
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Entity Type | Individual
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Provider Name | ERICK MANUEL RIVERA-GRANA MD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 91 CALLE UN
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City | PONCE
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State | PR
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Zip | 00730-3749
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Country | US
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Telephone | 787-460-6568
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Fax |
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Provider Business Mailing Address
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Address Line | 3181 SW SAM JACKSON PARK RD
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City | PORTLAND
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State | OR
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Zip | 97239-3011
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Country | US
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Telephone | 503-494-3000
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Fax | 503-494-4286
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD214392
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | 22299
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 207WX0108X
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Taxonomy Name | Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
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License Number | 22299
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License Number State | PR
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