Active NPI
Raymond Rivera, M.D.
- Surgery Physician
- Tarzana, CA
National Provider Identifier
1457540502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- G83979
- Practice address
- 5525 Etiwanda Ave
Suite 222
Tarzana, CA 91356-3647 - Phone
- (818) 345-9600
- NPI assigned
- Oct 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | G83979 | CA | Primary |
Addresses
Primary practice location
5525 Etiwanda Ave
Suite 222
Tarzana, CA 91356-3647
Mailing address
PO Box 507
Woodland Hills, CA 91365-0507
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83979 | CA | MD | Marriage & Family Therapist |
| G83979 | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198800000000",
"number": "1457540502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 507",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913650507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5525 ETIWANDA AVE",
"address_2": "SUITE 222",
"city": "TARZANA",
"state": "CA",
"postal_code": "913563647",
"telephone_number": "818-345-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-15",
"last_updated": "2007-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G83979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tarzana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.