Provider Demographics
NPI:1386197291
Name:RITCHIE, MATTHEW FRANCIS
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:FRANCIS
Last Name:RITCHIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 S TWIN OAKS VALLEY RD
Mailing Address - Street 2:APT 59
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-5310
Mailing Address - Country:US
Mailing Address - Phone:443-838-1901
Mailing Address - Fax:
Practice Address - Street 1:619 S TWIN OAKS VALLEY RD
Practice Address - Street 2:APT 59
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-5310
Practice Address - Country:US
Practice Address - Phone:443-838-1901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman