Provider Demographics
NPI:1508084690
Name:RIVES, ADAM WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:WARREN
Last Name:RIVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 DE LA VINA ST
Mailing Address - Street 2:STE 201
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3879
Mailing Address - Country:US
Mailing Address - Phone:805-682-2267
Mailing Address - Fax:805-687-3527
Practice Address - Street 1:2323 DE LA VINA ST STE 201
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105
Practice Address - Country:US
Practice Address - Phone:805-682-2267
Practice Address - Fax:805-563-0970
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA120223207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO475000008OtherMEDICARE PTAN
MO1508084690Medicaid
MO0388010001OtherDMERC