Provider Demographics
NPI:1245232685
Name:RIGGS, PEYTON (DO)
Entity Type:Individual
Prefix:
First Name:PEYTON
Middle Name:
Last Name:RIGGS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 S MILL ST
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-2027
Mailing Address - Country:US
Mailing Address - Phone:661-823-2273
Mailing Address - Fax:
Practice Address - Street 1:432 S MILL ST
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-2027
Practice Address - Country:US
Practice Address - Phone:661-823-2273
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF00094Medicare UPIN