Provider Demographics
NPI:1932274628
Name:RISPLER, MARK J (MD FACOG)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:RISPLER
Suffix:
Gender:M
Credentials:MD FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3500 N SEPULVEDA BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3639
Mailing Address - Country:US
Mailing Address - Phone:310-648-2229
Mailing Address - Fax:310-333-0666
Practice Address - Street 1:3500 N SEPULVEDA BLVD STE 130
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-3639
Practice Address - Country:US
Practice Address - Phone:310-648-2229
Practice Address - Fax:310-333-0666
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG047777207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G047777Medicare UPIN