MEDICARE: SCOTT RITCHEY SALE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	G85018	CA

General Provider Information

NPI Number	:	1063475986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT RITCHEY SALE MD

Provider Business Mailing Address
First Line	:	11645 WILSHIRE BLVD
Second Line	:	SUITE 1090
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1708
Country	:	US
Telephone Number	:	310-478-1188
Fax Number	:	310-478-9414

Provider Business Practice Location Address
First Line	:	11645 WILSHIRE BLVD
Second Line	:	SUITE 1090
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1708
Country	:	US
Telephone Number	:	310-478-1188
Fax Number	:	310-478-9414

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	07/13/2007

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Directions to “ SCOTT RITCHEY SALE MD” Practice Location

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