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NPI Code Detail

MEDICARE: DR. RICARDO PUERTAS MD

MEDICARE: DR. RICARDO PUERTAS 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
1207Q00000XFamily Medicine PhysicianG76685CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G76685OTHERCASTAE LICENSE

General Provider Information

NPI Number : 1861573230
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICARDO PUERTAS MD
Provider Business Mailing Address
First Line : 5427 WHITTIER BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-4101
Country : US
Telephone Number : 323-869-1900
Fax Number : 323-869-5362
Provider Business Practice Location Address
First Line : 5427 WHITTIER BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-4101
Country : US
Telephone Number : 323-869-1900
Fax Number : 323-869-5362
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 03/07/2023

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Directions to “ DR. RICARDO PUERTAS MD” Practice Location

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