Provider Demographics
NPI:1700835675
Name:RIGOR, RONALD O (MD,)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:O
Last Name:RIGOR
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 1:675 S ARROYO PKWY
Mailing Address - Street 2:100
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3263
Mailing Address - Country:US
Mailing Address - Phone:626-844-3884
Mailing Address - Fax:626-844-3886
Practice Address - Street 1:675 S ARROYO PKWY
Practice Address - Street 2:100
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3263
Practice Address - Country:US
Practice Address - Phone:626-844-3884
Practice Address - Fax:626-844-3886
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36475207N00000X
CAA92405207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABT689AOtherMEDICARE GROUP PTAN
IA0268292Medicaid
CABT687ZOtherMEDICARE PTAN
IL036101791Medicaid
CAI52007Medicare UPIN
IA0268292Medicaid
CAWA92405AMedicare PIN
CAI52007Medicare UPIN
IL036101791Medicaid