Provider Demographics
NPI:1568919157
Name:CATALA RIVERA, PATRICIA NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:NICOLE
Last Name:CATALA RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:424-440-0472
Mailing Address - Fax:310-301-8751
Practice Address - Street 1:100 UCLA MEDICAL PLAZA SUITE 250
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1625
Practice Address - Country:US
Practice Address - Phone:310-794-9830
Practice Address - Fax:310-794-9824
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA182959207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program