Ernesto Javier Rivera Jr.
Student in an Organized Health Care Education/Training Program in San Diego, CA. Individual provider (NPI-1).
NPI number1962086702
StatusActive
Last updated in NPPESMar 15, 2024
Details
- NPI
- 1962086702
- Entity type
- Individual (NPI-1)
- Name
- Ernesto Javier Rivera Jr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 7, 2021
- Certification date
- Mar 15, 2024
- Last updated
- Mar 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
200 W Arbor Dr # Mc8425San Diego, CA 92103-1911
Phone 619-543-6268
Mailing address
200 W Arbor Dr # Mc8425San Diego, CA 92103-1911
Phone 619-543-6268
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