Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 55156 | CA |
NPI | 1740735737 |
---|---|
Provider Name | Rick Rieser |
First Address | Los Angeles, CA 90057-3158 |
Second Address | Los Angeles, CA 90057-3158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2016 |
Last Update Date | 18/08/2016 |