MEDICARE: DR. RAND CECIL RITCHIE 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	2084P0800X	Psychiatry Physician	G41327	CA
2	2084P0802X	Addiction Psychiatry Physician	G41327	CA

General Provider Information

NPI Number	:	1851325484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAND CECIL RITCHIE MD

Provider Business Mailing Address
First Line	:	354 MAIN ST
Second Line	:	SUITE C
City	:	PISMO BEACH
State	:	CA
Zip	:	93449-2514
Country	:	US
Telephone Number	:	805-773-3343
Fax Number	:	805-773-3342

Provider Business Practice Location Address
First Line	:	354 MAIN ST
Second Line	:	SUITE C
City	:	PISMO BEACH
State	:	CA
Zip	:	93449-2514
Country	:	US
Telephone Number	:	805-773-3343
Fax Number	:	805-773-3342

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	12/13/2013

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