Provider Demographics
NPI:1013940410
Name:KRIPPS, MARVIN MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:MARTIN
Last Name:KRIPPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MARVIN
Other - Middle Name:MARTIN
Other - Last Name:KRIPPS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MARVIN KRIPPS, MD
Mailing Address - Street 1:243 S ESCONDIDO BLVD # 324 PMB #
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4116
Mailing Address - Country:US
Mailing Address - Phone:760-747-5993
Mailing Address - Fax:760-747-3123
Practice Address - Street 1:225 E 2ND AVE
Practice Address - Street 2:SUITE#202
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4212
Practice Address - Country:US
Practice Address - Phone:760-747-5993
Practice Address - Fax:760-747-3123
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA20485207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA22183Medicare UPIN