Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edwin Rivera, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1861474033

Edwin Rivera, PHYSICIANASSISTANT is a Physician Assistant in San Diego, California. Qualified in 1997, 29 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
29
Licensed in
CA
In the registry since
2005
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Practice location Address checks out

4647 Zion Ave
San Diego, CA 92120-2507
Phone: (619) 528-2595
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA14420 (CA)

Record details

NPI number1861474033
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedNovember 15, 2005
Last updated in NPPESNovember 29, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in San Diego