Provider Demographics
NPI:1609880111
Name:TRIPP, ARNOLD H (RPT)
Entity Type:Individual
Prefix:MR
First Name:ARNOLD
Middle Name:H
Last Name:TRIPP
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92033-0268
Mailing Address - Country:US
Mailing Address - Phone:760-738-8811
Mailing Address - Fax:760-738-8886
Practice Address - Street 1:1318 MOUNTAIN PARK PLACE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027
Practice Address - Country:US
Practice Address - Phone:760-738-8811
Practice Address - Fax:760-738-8886
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT3422225100000X
CAEN82251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT3422AMedicare PIN