Most Relevant Information
Provider Data
| NPI Number: | 1003214297 |
| Provider Name: | SHANNON RIVERA PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 52148 |
Most Important Dates
| Enumeration Date: | 12/20/2014 |
| Last Updated: | 12/13/2021 |
Provider Practice Location
1115 S SUNSET AVE
WEST COVINA
CA
917903940
Practice Location Phone/Fax
| Phone: | 6269624011 |
| Fax: |
Provider Mailing Location
9449 IMPERIAL HWY
DOWNEY
CA
902422814
Provider Mailing Phone/Fax
| Phone: | 5626574530 |
| Fax: |