Provider Demographics
NPI:1124023486
Name:RIGER, BRUCE N (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:N
Last Name:RIGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1227
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-1227
Mailing Address - Country:US
Mailing Address - Phone:530-842-9800
Mailing Address - Fax:530-842-9054
Practice Address - Street 1:475 BRUCE ST STE 700
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-3473
Practice Address - Country:US
Practice Address - Phone:530-842-9800
Practice Address - Fax:530-842-9054
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84338207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110176737OtherRAILROAD MEDICARE
E69398Medicare UPIN
CA110176737OtherRAILROAD MEDICARE