Provider Demographics
NPI:1932346707
Name:JONATHAN RIEGLER, M.D., INC.
Entity Type:Organization
Organization Name:JONATHAN RIEGLER, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-226-4106
Mailing Address - Street 1:1255 LAS TABLAS RD
Mailing Address - Street 2:STE 201
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-9748
Mailing Address - Country:US
Mailing Address - Phone:805-226-4106
Mailing Address - Fax:805-226-4108
Practice Address - Street 1:1255 LAS TABLAS RD
Practice Address - Street 2:STE 201
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-9748
Practice Address - Country:US
Practice Address - Phone:805-226-4106
Practice Address - Fax:805-226-4108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABV897AMedicare PIN