Healthcare Provider Details

I. General information

NPI: 1336175082
Provider Name (Legal Business Name): RUTH ANN ACKERMANN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 PACIFIC COAST HWY SUITE #110
TORRANCE CA
90505-6658
US

IV. Provider business mailing address

PO BOX 4148
TORRANCE CA
90510-4148
US

V. Phone/Fax

Practice location:
  • Phone: 310-325-4555
  • Fax: 310-325-5005
Mailing address:
  • Phone: 310-792-3914
  • Fax: 310-792-3621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA46287
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: