Basic Information
| Provider Information | |||||||||
| NPI: | 1700835675 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIGOR | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | O | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., | ||||||||
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| Mailing Information | |||||||||
| Address1: | 675 S ARROYO PKWY | ||||||||
| Address2: | 100 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911053263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6268443884 | ||||||||
| FaxNumber: | 6268443886 | ||||||||
| Practice Location | |||||||||
| Address1: | 675 S ARROYO PKWY | ||||||||
| Address2: | 100 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911053263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6268443884 | ||||||||
| FaxNumber: | 6268443886 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2006 | ||||||||
| LastUpdateDate: | 11/20/2014 | ||||||||
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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 | 207N00000X | 36475 | IA | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | A92405 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology |
ID Information
| ID | Type | State | Issuer | Description | BT689A | 01 | CA | MEDICARE GROUP PTAN | OTHER | 0268292 | 05 | IA | MEDICAID | BT687Z | 01 | CA | MEDICARE PTAN | OTHER | 036101791 | 05 | IL | MEDICAID |