1336144633 NPI number — LEON A RIGBERG M.D.

Table of content: LEON A RIGBERG M.D. (NPI 1336144633)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336144633 NPI number — LEON A RIGBERG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIGBERG
Provider First Name:
LEON
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336144633
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3501 N SCOTTSDALE RD
Provider Second Line Business Mailing Address:
SUITE 320
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85251-5648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-424-7228
Provider Business Mailing Address Fax Number:
480-424-7317

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3501 N SCOTTSDALE RD
Provider Second Line Business Practice Location Address:
STE 320
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85251-5650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-424-7228
Provider Business Practice Location Address Fax Number:
480-424-7317
Provider Enumeration Date:
06/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  9296 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 21516202 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 626894 . This is a "AETNA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860361052 . This is a "CCN" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 860361025A . This is a "FIRST HEALTH" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860361052 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AZ0047010 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 1Z1836 . This is a "HEALTHNET" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 4279400 . This is a "CIGNA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860361052 . This is a "ARIZONA FOUNDATION MEDICA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 215162-002 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 15447 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 3215162 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 860361052 . This is a "HUMANA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 05306 . This is a "PACIFICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 215162 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 860361052A . This is a "FIRST HEALTH" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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