Provider Demographics
NPI:1710955570
Name:RICCI, RICHARD RALPH (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:RALPH
Last Name:RICCI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:332 S JUNIPER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4941
Mailing Address - Country:US
Mailing Address - Phone:760-291-6621
Mailing Address - Fax:760-737-3430
Practice Address - Street 1:225 EAST 2ND AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4249
Practice Address - Country:US
Practice Address - Phone:866-228-2236
Practice Address - Fax:760-737-7367
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2015-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG48803207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB236360OtherMEDICARE PTAN
CAF11874Medicare UPIN