IndividualActive
Diana Betancourt, MS, LAT, ATC
NPI 1669188165 · Sports Medicine (Emergency Medicine) Physician · Riverside, MO
Provider details
- NPI number
- 1669188165
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Emergency Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MS, LAT, ATC
- Sex
- Female
- Sole proprietor
- No
- License
- 24-01780 (KS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1 Teal Rising Way
Riverside, MO 64150-7700
Phone: (714) 791-3647
Approximate (ZIP-level) locationGet directions
Mailing address
1 Teal Rising Way
Riverside, MO 64150-7700
Registry dates
- Enumerated
- 2023-01-27
- Last updated
- 2026-06-01
- Certified
- 2026-06-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.