Provider Demographics
NPI:1477976074
Name:RIZZOLO, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:RIZZOLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 MONO AVE.
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530
Mailing Address - Country:US
Mailing Address - Phone:510-620-0534
Mailing Address - Fax:
Practice Address - Street 1:2340 MONO AVE
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-1646
Practice Address - Country:US
Practice Address - Phone:510-620-0534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist