Basic Information
| Provider Information | |||||||||
| NPI: | 1336452333 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIVERA | ||||||||
| FirstName: | RACHELLE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 780 KUENZLI ST | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895020845 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7759825262 | ||||||||
| FaxNumber: | 7759825496 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 PRINGLE WAY | ||||||||
| Address2: | SUITE 512 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895021464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7759823866 | ||||||||
| FaxNumber: | 7759823868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2010 | ||||||||
| LastUpdateDate: | 03/23/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301097339 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0200X | 16291 | NV | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.