Provider Demographics
NPI:1932580644
Name:RIPA, MADELINE DIANNE (MD)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:DIANNE
Last Name:RIPA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3035 CLEVELAND AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-3037
Mailing Address - Country:US
Mailing Address - Phone:707-546-9800
Mailing Address - Fax:
Practice Address - Street 1:3035 CLEVELAND AVE STE 100
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-3037
Practice Address - Country:US
Practice Address - Phone:707-546-9800
Practice Address - Fax:707-899-7980
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-18
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125067960207W00000X
UT11191801-1205207W00000X
MO2015019310207W00000X
IL036.151523207WX0120X
CAC200556207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist