Provider Demographics
NPI:1396451027
Name:RIPS, MATTHEW EVAN (PA-C)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:EVAN
Last Name:RIPS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 STATE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-5101
Mailing Address - Country:US
Mailing Address - Phone:805-687-8378
Mailing Address - Fax:
Practice Address - Street 1:3905 STATE ST STE 3
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-5101
Practice Address - Country:US
Practice Address - Phone:805-687-8378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
CA62640363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA62640OtherSTATE