Provider Demographics
NPI:1770775850
Name:RIVAS, NERY ORLANDO (DC)
Entity type:Individual
Prefix:DR
First Name:NERY
Middle Name:ORLANDO
Last Name:RIVAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 CORINTH AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1622
Mailing Address - Country:US
Mailing Address - Phone:310-481-7160
Mailing Address - Fax:
Practice Address - Street 1:4435 CANOGA AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-4436
Practice Address - Country:US
Practice Address - Phone:818-710-8730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor