Provider Demographics
NPI:1538144290
Name:RIGGLE, PAUL CURTIS (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:CURTIS
Last Name:RIGGLE
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 1:2660 W COVELL BLVD
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-5645
Mailing Address - Country:US
Mailing Address - Phone:530-747-3000
Mailing Address - Fax:
Practice Address - Street 1:2660 W COVELL BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-5645
Practice Address - Country:US
Practice Address - Phone:530-747-3000
Practice Address - Fax:530-747-3080
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA045554207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E30483Medicare UPIN
CA00A455540Medicare ID - Type Unspecified
00A455540Medicare PIN