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1629464474 NPI number — ANDREW ROBERT RIVERA MD

NPI Number: 1629464474
Health Care Provider/Practitioner: ANDREW ROBERT RIVERA MD

Information about “1629464474” NPI (ANDREW ROBERT RIVERA MD) exists in 1629464474 in HTML format HTML  |  1629464474 in plain Text format TXT  |  1629464474 in PDF (Portable Document Format) PDF  |  1629464474 in an XML format XML  formats.

NPI Number : 1629464474 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629464474",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RIVERA",
    "FirstName": "ANDREW",
    "MiddleName": "ROBERT",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RIVERA-HOBER",
    "OtherFirstName": "ANDREW",
    "OtherMiddleName": "ROBERT",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "500 JEFFERSON AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "REDWOOD CITY",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94063-1791",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "480-532-7294",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6001 NORRIS CANYON RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN RAMON",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94583-5400",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "925-275-9200",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/08/2015",
    "LastUpdateDate": "09/26/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "60956782",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "180547",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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