Healthcare Provider Details

I. General information

NPI: 1487633103
Provider Name (Legal Business Name): DANIEL F. KRIPKE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10666 N TORREY PINES RD
LA JOLLA CA
92037-1027
US

IV. Provider business mailing address

FILE# 54433
LOS ANGELES CA
90074-0001
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-8845
  • Fax: 858-784-5922
Mailing address:
  • Phone: 858-784-5906
  • Fax: 858-784-5922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG18150
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: