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General NPI Number Information
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NPI Number | 1891967402
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Entity Type | Organization
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Legal Business Name | RAMONA OAKS FAMILY MEDICINE INC
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Dates
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Enumeration Date | 03/24/2008
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 23678 SAN VICENTE RD
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City | RAMONA
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State | CA
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Zip | 92065-4245
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Country | US
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Telephone | 760-789-8812
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Fax | 760-788-9862
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Provider Business Mailing Address
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Address Line | 23678 SAN VICENTE RD
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City | RAMONA
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State | CA
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Zip | 92065-4245
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Country | US
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Telephone | 760-789-8812
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Fax | 760-788-9862
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Authorized Official
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Title or Position | CEO
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Name | JAMES M RICKETTS
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Credential | D.O.
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Telephone | 760-789-8812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 20A4384
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License Number State | CA
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