Provider Demographics
NPI:1083764708
Name:ERIC RYPINS MD FACS APC
Entity Type:Organization
Organization Name:ERIC RYPINS MD FACS APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOCORRO
Authorized Official - Middle Name:B
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-732-1166
Mailing Address - Street 1:2424 VISTA WAY STE 106
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6178
Mailing Address - Country:US
Mailing Address - Phone:760-732-1166
Mailing Address - Fax:760-732-1130
Practice Address - Street 1:2424 VISTA WAY STE 106
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6178
Practice Address - Country:US
Practice Address - Phone:760-732-1166
Practice Address - Fax:760-732-1130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47250174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G472500Medicaid
CAG47250Medicare PIN