Healthcare Provider Details

I. General information

NPI: 1629155254
Provider Name (Legal Business Name): ROBERT J. RIOPELLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 12/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 MILLER AVE STE 101
MILL VALLEY CA
94941-2851
US

IV. Provider business mailing address

PO BOX 32
MILL VALLEY CA
94942-0032
US

V. Phone/Fax

Practice location:
  • Phone: 415-922-2028
  • Fax:
Mailing address:
  • Phone: 415-922-2028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA21700
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: