MEDICARE: DAVID RIZZOLO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1477976074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID RIZZOLO

Provider Business Mailing Address
First Line	:	2340 MONO AVE.
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530
Country	:	US
Telephone Number	:	510-620-0534
Fax Number	:

Provider Business Practice Location Address
First Line	:	2340 MONO AVE
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-1646
Country	:	US
Telephone Number	:	510-620-0534
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2014
Last Update Date	:	02/03/2014

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Directions to “ DAVID RIZZOLO ” Practice Location

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