Provider Demographics
NPI:1780848192
Name:RITACHKA, GEORGE JR (LAC)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:RITACHKA
Suffix:JR
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2658 DEL MAR HEIGHTS RD # 136
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-3100
Mailing Address - Country:US
Mailing Address - Phone:858-342-9770
Mailing Address - Fax:
Practice Address - Street 1:1200 GARDEN VIEW RD STE 106
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2475
Practice Address - Country:US
Practice Address - Phone:858-342-9770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9046171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist