Riverlakes Wellness Medical Group, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

RIVERLAKES WELLNESS MEDICAL GROUP, INC.

Practice address

3900 Coffee Rd
Suite 3
Bakersfield, CA 93308-5049

Phone

(661) 588-5808

Fax

(805) 369-1309

NPI assigned

Jun 18, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bryan David Hixson

Title

Manager

Phone

(805) 369-1305

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1083819254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 COFFEE RD",
            "address_2": "SUITE 3",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933085049",
            "telephone_number": "661-588-5808",
            "fax_number": "805-369-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 COFFEE RD",
            "address_2": "SUITE 3",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933085049",
            "telephone_number": "661-588-5808",
            "fax_number": "805-369-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERLAKES WELLNESS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "HIXSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "805-369-1305"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodolfo Rivera Jr.
• Steven Caraveo Rivera Jr., BSP
• Victoria Elizabeth Rivera
• Yolanda A Rivera
• Riverlakes Surgery Center LLC
• Tamla Noel Rivers
• Riverwalk Assisted Care LLC
• Riverwalk Medical Corporation
• Riverwalk Medical Corporation
• Riverwalk Pediatric Clinic Inc

• Primary Care Clinic/Center in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.