Provider Demographics
NPI:1821476292
Name:RIPP, KAMBRIA
Entity Type:Individual
Prefix:
First Name:KAMBRIA
Middle Name:
Last Name:RIPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAMBRIA
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 E 28TH ST STE 419
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2775
Mailing Address - Country:US
Mailing Address - Phone:562-490-9900
Mailing Address - Fax:
Practice Address - Street 1:701 E 28TH ST STE 419
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2775
Practice Address - Country:US
Practice Address - Phone:562-490-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA146257208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program