Individual provider Active NPI

Edward Lawrence Riceberg, M.D.

  • Internal Medicine Physician
  • Beverly Hills, CA
National Provider Identifier
1861558173
Registry record updated Dec 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A22329 Issued in CA
Practice address
9400 Brighton Way
Suite #201
Beverly Hills, CA 90210-4714
Phone
(310) 550-8028
Fax
(310) 278-1570
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A22329 CA Primary

Addresses

Primary practice location

9400 Brighton Way
Suite #201
Beverly Hills, CA 90210-4714

Mailing address

9400 Brighton Way
Suite #201
Beverly Hills, CA 90210-4714
Phone (310) 550-8028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080603000246 CA Practitioner - Internal MedicinePractitioner - Addiction Medicine 6709956790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A22329CAMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1861558173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 BRIGHTON WAY",
            "address_2": "SUITE #201",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104714",
            "telephone_number": "310-550-8028",
            "fax_number": "310-278-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 BRIGHTON WAY",
            "address_2": "SUITE #201",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104714",
            "telephone_number": "310-550-8028",
            "fax_number": "310-278-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICEBERG",
        "first_name": "EDWARD",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A22329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.