Ricketts, James M

Ricketts, James M is an individual health care provider with primary practice located at 1347 Tavern Rd Ste 9, Alpine CA 91901-3853. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ricketts, James M can be contacted via phone (619) 445-0204.

Contact Information

Primary practice address
1347 Tavern Rd Ste 9 Alpine CA 91901-3853
Phone: (619) 445-0204
Fax: (619) 659-0205
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20A4384 California

Profile Details

NPI number 1932218047
LBN Legal business name Ricketts, James M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932218047 NPPES
California Other ZZZ48102Z BLUE SHIELD
California MEDICAID 00AX43840 BLUE SHIELD

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