Provider Demographics
NPI:1639324205
Name:RIVAS, CINTHIA (LAC)
Entity Type:Individual
Prefix:
First Name:CINTHIA
Middle Name:
Last Name:RIVAS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:M
Other - Last Name:RIVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3647 EMPIRE DR APT 201
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-5076
Mailing Address - Country:US
Mailing Address - Phone:310-529-9104
Mailing Address - Fax:310-672-5323
Practice Address - Street 1:3647 EMPIRE DR APT 201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-5076
Practice Address - Country:US
Practice Address - Phone:310-529-9104
Practice Address - Fax:310-672-5323
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12479171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist