Provider Demographics
NPI:1841485455
Name:ROBERT W RIGG JR. MD
Entity type:Organization
Organization Name:ROBERT W RIGG JR. MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGG
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:818-709-5700
Mailing Address - Street 1:20181 SATICOY ST
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91306-2506
Mailing Address - Country:US
Mailing Address - Phone:818-709-5700
Mailing Address - Fax:818-709-8214
Practice Address - Street 1:20181 SATICOY ST
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91306-2506
Practice Address - Country:US
Practice Address - Phone:818-709-5700
Practice Address - Fax:818-709-8214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG050286208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA89913Medicare UPIN
CAW9345Medicare PIN