Healthcare Provider Details

I. General information

NPI: 1598819898
Provider Name (Legal Business Name): RITCHKEN AND FIRST MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 05/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4282 GENESEE AVE SUITE 103
SAN DIEGO CA
92117-4961
US

IV. Provider business mailing address

4282 GENESEE AVE SUITE 103
SAN DIEGO CA
92117-4961
US

V. Phone/Fax

Practice location:
  • Phone: 858-292-0108
  • Fax: 858-292-9097
Mailing address:
  • Phone: 858-292-0108
  • Fax: 858-292-9097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberA33952
License Number StateCA

VIII. Authorized Official

Name: MRS. MARIBEL ALEXANDER
Title or Position: OFFICE MANAGER
Credential:
Phone: 858-292-0108