MEDICARE: PAUL CURTIS RIGGLE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A045554	CA

General Provider Information

NPI Number	:	1538144290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL CURTIS RIGGLE M.D.

Provider Business Mailing Address
First Line	:	2660 W COVELL BLVD
Second Line	:
City	:	DAVIS
State	:	CA
Zip	:	95616-5645
Country	:	US
Telephone Number	:	530-747-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2660 W COVELL BLVD
Second Line	:	SUITE C
City	:	DAVIS
State	:	CA
Zip	:	95616-5645
Country	:	US
Telephone Number	:	530-747-3000
Fax Number	:	530-747-3080

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	12/14/2007

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