Provider Demographics
NPI:1285644286
Name:RIBERA, ERNEST F (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:F
Last Name:RIBERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1720 EL CAMINO REAL
Mailing Address - Street 2:SUITE 155
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3231
Mailing Address - Country:US
Mailing Address - Phone:650-342-6506
Mailing Address - Fax:650-340-9032
Practice Address - Street 1:1720 EL CAMINO REAL
Practice Address - Street 2:SUITE 155
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3231
Practice Address - Country:US
Practice Address - Phone:650-342-6506
Practice Address - Fax:650-340-9032
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG42044207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG42044OtherLICENSE
CAA48792Medicare UPIN
CAG42044OtherLICENSE