IndividualActive
Tony Rivera, ATC
NPI 1508712043 · Sports Medicine (Emergency Medicine) Physician · Riverside, CA
Provider details
- NPI number
- 1508712043
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Emergency Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- Yes
- License
- 2000058675 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3169 Juanita St
Riverside, CA 92504-4513
Phone: (909) 641-1711
Approximate (ZIP-level) locationGet directions
Mailing address
3169 Juanita St
Riverside, CA 92504-4513
Registry dates
- Enumerated
- 2026-03-06
- Last updated
- 2026-03-06
- Certified
- 2026-03-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.