Basic Information
| Provider Information | |||||||||
| NPI: | 1700191285 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RIFENBARK | ||||||||
| FirstName: | NEIL | ||||||||
| MiddleName: | PETREE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 W CARSON ST # 461 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102222700 | ||||||||
| FaxNumber: | 3105331841 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 W CARSON ST # 461 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102222700 | ||||||||
| FaxNumber: | 3105331841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2010 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 2017-02180 | NC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | A124061 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.