Provider Demographics
NPI:1972835692
Name:RIOS, EUNICE VALERIE (MD)
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:VALERIE
Last Name:RIOS
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:PO BOX 2072
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:CA
Mailing Address - Zip Code:91746-0072
Mailing Address - Country:US
Mailing Address - Phone:323-677-9192
Mailing Address - Fax:
Practice Address - Street 1:IRD 115; 1200 N STATE STREET
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089
Practice Address - Country:US
Practice Address - Phone:323-226-5610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110868207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine