Provider Demographics
NPI:1427687680
Name:RIVERA, NATALIE (MD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name: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 1:19330 JESSE LN STE 100
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-5077
Mailing Address - Country:US
Mailing Address - Phone:844-827-8000
Mailing Address - Fax:951-236-7237
Practice Address - Street 1:19330 JESSE LN STE 100
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-5077
Practice Address - Country:US
Practice Address - Phone:844-827-8000
Practice Address - Fax:951-236-7237
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA192170207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program