MEDICARE: SARAH RUTH RETTINGER 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	207R00000X	Internal Medicine Physician	A88064	CA
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	A88064	CA

General Provider Information

NPI Number	:	1366691842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH RUTH RETTINGER MD

Provider Business Mailing Address
First Line	:	725 W LA VETA AVE
Second Line	:	SUITE 220
City	:	ORANGE
State	:	CA
Zip	:	92868-4403
Country	:	US
Telephone Number	:	714-771-5700
Fax Number	:	714-771-9977

Provider Business Practice Location Address
First Line	:	1831 WILSHIRE BLVD STE A
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-5778
Country	:	US
Telephone Number	:	310-829-8584
Fax Number	:	424-291-4205

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

Provider Enumeration Date	:	09/09/2008
Last Update Date	:	04/19/2021

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