Provider Demographics
NPI:1679772867
Name:J TREES RITTER, DO, INC.
Entity Type:Organization
Organization Name:J TREES RITTER, DO, INC.
Other - Org Name:CENTRAL COAST ID CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:TREES
Authorized Official - Last Name:RITTER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:805-305-5296
Mailing Address - Street 1:PO BOX 1206
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93116-1206
Mailing Address - Country:US
Mailing Address - Phone:805-540-0689
Mailing Address - Fax:
Practice Address - Street 1:1551 BISHOP ST STE 250
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4661
Practice Address - Country:US
Practice Address - Phone:805-540-0689
Practice Address - Fax:805-541-1376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8407207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH82712Medicare UPIN