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General NPI Number Information
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NPI Number | 1659894822
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Entity Type | Organization
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Legal Business Name | CECILIA A RIVAS OD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 07/19/2017
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Provider Practice Location Address
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Address Line | 11729 IMPERIAL HWY
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City | NORWALK
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State | CA
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Zip | 90650-2819
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Country | US
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Telephone | 562-860-4094
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1051
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City | TORRANCE
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State | CA
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Zip | 90505-0051
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Country | US
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Telephone | 562-201-7740
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CECILIA ALEJANDRA RIVAS
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Credential | DO
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Telephone | 562-860-4094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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