Healthcare Provider Details

I. General information

NPI: 1134423452
Provider Name (Legal Business Name): JAMES KEMP RIBE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2010
Last Update Date: 12/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18156 KINGSPORT DR
MALIBU CA
90265-5634
US

IV. Provider business mailing address

18156 KINGSPORT DR
MALIBU CA
90265-5634
US

V. Phone/Fax

Practice location:
  • Phone: 323-343-0520
  • Fax: 323-225-2752
Mailing address:
  • Phone: 323-343-0520
  • Fax: 323-225-2752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License NumberG56800
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: