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NPI Code Detail

MEDICARE: MRS. DOLORES CENA RIVAS

MEDICARE: MRS. DOLORES CENA RIVAS
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1891064317
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DOLORES CENA RIVAS
Provider Business Mailing Address
First Line : 9680 W TROPICANA AVE STE 133
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-8293
Country : US
Telephone Number : 562-446-7721
Fax Number :
Provider Business Practice Location Address
First Line : 6205 MERCER VALLEY ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89081-6511
Country : US
Telephone Number : 562-446-7721
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2011
Last Update Date : 12/29/2011

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