Basic Information
| Provider Information | |||||||||
| NPI: | 1962766980 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RIVADENEYRA PASTEN | ||||||||
| FirstName: | HUGO | ||||||||
| MiddleName: | ALEJANDRO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1215 DUFF AVENUE | ||||||||
| Address2: | |||||||||
| City: | AMES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500103014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152394440 | ||||||||
| FaxNumber: | 5152394420 | ||||||||
| Practice Location | |||||||||
| Address1: | 1015 DUFF AVENUE | ||||||||
| Address2: | |||||||||
| City: | AMES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500103014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152394440 | ||||||||
| FaxNumber: | 5152394420 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2012 | ||||||||
| LastUpdateDate: | 01/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 44311 | IA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.