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General NPI Number Information
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NPI Number | 1912898446
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Entity Type | Individual
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Provider Name | JOSHUA IAN RIVAS
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Gender | Male
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Dates
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Enumeration Date | 07/12/2025
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Last Update Date | 07/12/2025
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Provider Practice Location Address
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Address Line | 3000 N HOLLYWOOD WAY STE 103
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City | BURBANK
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State | CA
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Zip | 91505-1026
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Country | US
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Telephone | 818-736-5828
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Fax |
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Provider Business Mailing Address
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Address Line | 521 N PENNSYLVANIA AVE
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City | GLENDORA
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State | CA
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Zip | 91741-2040
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Country | US
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Telephone | 626-824-0897
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 88562
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License Number State | CA
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