Healthcare Provider Details

I. General information

NPI: 1366691842
Provider Name (Legal Business Name): SARAH RUTH RETTINGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 WILSHIRE BLVD STE A
SANTA MONICA CA
90403-5778
US

IV. Provider business mailing address

725 W LA VETA AVE SUITE 220
ORANGE CA
92868-4403
US

V. Phone/Fax

Practice location:
  • Phone: 310-829-8584
  • Fax: 424-291-4205
Mailing address:
  • Phone: 714-771-5700
  • Fax: 714-771-9977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA88064
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA88064
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: