Provider Demographics
NPI:1518912617
Name:KAW, MARIA CECILIA RIVERA (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARIA CECILIA
Middle Name:RIVERA
Last Name:KAW
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1675
Mailing Address - Country:US
Mailing Address - Phone:714-932-9275
Mailing Address - Fax:
Practice Address - Street 1:823 S MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3421
Practice Address - Country:US
Practice Address - Phone:951-279-3125
Practice Address - Fax:951-279-3127
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH50013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist