Provider Demographics
NPI:1629022363
Name:TROTTER, RUTH PRANGE (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:PRANGE
Last Name:TROTTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 BUNKER HILL WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-6013
Mailing Address - Country:US
Mailing Address - Phone:831-796-1304
Mailing Address - Fax:831-757-0291
Practice Address - Street 1:1150 FREMONT BLVD
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955-5715
Practice Address - Country:US
Practice Address - Phone:831-899-8100
Practice Address - Fax:831-899-8105
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ15686ZOtherMEDICARE GROUP
CAZZZ15686ZOtherMEDICARE GROUP