Healthcare Provider Details

I. General information

NPI: 1760911523
Provider Name (Legal Business Name): RICARDO FLIPPEN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 E CENTER AVE
VISALIA CA
93291-6331
US

IV. Provider business mailing address

305 E CENTER AVE
VISALIA CA
93291-6331
US

V. Phone/Fax

Practice location:
  • Phone: 559-737-4792
  • Fax: 559-734-1247
Mailing address:
  • Phone: 559-737-4792
  • Fax: 559-734-1247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number54476
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: