Provider Demographics
NPI:1952349417
Name:RIGGS, JOHN JAY (OD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JAY
Last Name:RIGGS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3257 CAMINO DE LOS COCHES
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009
Mailing Address - Country:US
Mailing Address - Phone:760-942-3937
Mailing Address - Fax:760-942-5143
Practice Address - Street 1:3257 CAMINO DE LOS COCHES
Practice Address - Street 2:SUITE 201
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009
Practice Address - Country:US
Practice Address - Phone:760-942-3937
Practice Address - Fax:760-942-5143
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 7322 TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0073220Medicaid
CASD0073220Medicaid
CAT70188Medicare UPIN
CAOP 7322Medicare ID - Type Unspecified