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General NPI Number Information
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NPI Number | 1467629436
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Entity Type | Individual
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Provider Name | JOSEPH MICHAEL RIBAUDO MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 2120 COWELL BLVD STE 142
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City | DAVIS
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State | CA
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Zip | 95618-7835
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Country | US
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Telephone | 301-330-6203
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Fax | 301-330-6206
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Provider Business Mailing Address
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Address Line | 1 BANK ST STE 220
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1504
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Country | US
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Telephone | 301-330-6203
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Fax | 301-330-6206
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | C42686
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 246503-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD010663
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License Number State | LA
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