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General NPI Number Information
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NPI Number | 1730624420
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Entity Type | Organization
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Legal Business Name | DAVID RIVERA CHIROPRACTIC, INC
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Dates
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Enumeration Date | 01/04/2017
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 29211 S WESTERN AVE SUITE C
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-5682
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Country | US
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Telephone | 310-514-3740
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Fax | 310-514-3723
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Provider Business Mailing Address
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Address Line | 29211 S WESTERN AVE SUITE C
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-5682
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Country | US
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Telephone | 310-514-3740
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Fax | 310-514-3723
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Authorized Official
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Title or Position | DOCTOR/ CEO
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Name | DAVID E RIVERA
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Credential | D.C.
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Telephone | 310-514-3740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC25922
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License Number State | CA
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