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General NPI Number Information
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NPI Number | 1497829949
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Entity Type | Organization
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Legal Business Name | JAVIER R RIOS MD A MEDICAL PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 3770 S 16TH AVE
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City | TUCSON
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State | AZ
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Zip | 85713-6081
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Country | US
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Telephone | 520-620-1200
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Fax | 520-620-1400
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Provider Business Mailing Address
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Address Line | 495 E RINCON ST STE 215
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City | CORONA
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State | CA
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Zip | 92879-1378
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Country | US
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Telephone | 951-523-0117
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Fax | 951-394-0685
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Authorized Official
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Title or Position | CEO/ MEDICAL DIRECTOR
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Name | DR. JAVIER R RIOS
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Credential | MD
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Telephone | 951-523-0117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30370
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License Number State | AZ
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