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General NPI Number Information
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NPI Number | 1609961929
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Entity Type | Individual
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Provider Name | RICARDO RIVAS-PLATA
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 675 S ARROYO PKWY STE 200
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City | PASADENA
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State | CA
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Zip | 91105-3215
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Country | US
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Telephone | 626-585-4120
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 714-443-4512
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G79354
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License Number State | CA
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