Rivera, Shane

Rivera, Shane is an individual health care provider with primary practice located at 5053 Astor Ave , Commerce CA 90040-1301. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Rivera, Shane can be contacted via phone (323) 722-4529.

Contact Information

Primary practice address
5053 Astor Ave Commerce CA 90040-1301
Phone: (323) 722-4529
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X California

Profile Details

NPI number 1487015707
LBN Legal business name Rivera, Shane
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2016
Last updated Mar 14th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487015707 NPPES
California Other 02768010 DRUG MEDI-CAL

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