Provider Demographics
NPI:1366691842
Name:RETTINGER, SARAH RUTH (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RUTH
Last Name:RETTINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:725 W LA VETA AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4403
Mailing Address - Country:US
Mailing Address - Phone:714-771-5700
Mailing Address - Fax:714-771-9977
Practice Address - Street 1:1831 WILSHIRE BLVD STE A
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5778
Practice Address - Country:US
Practice Address - Phone:310-829-8584
Practice Address - Fax:424-291-4205
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88064207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB211888Medicare PIN