Provider Demographics
NPI:1841579414
Name:MESTRES, RICARDO ANGELO III (MD)
Entity Type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:ANGELO
Last Name:MESTRES
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:151 VOYAGE MALL
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-7296
Mailing Address - Country:US
Mailing Address - Phone:310-600-0141
Mailing Address - Fax:
Practice Address - Street 1:1200 N STATE ST RM 1018
Practice Address - Street 2:DEPT OF EMERGENCY MEDICINE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1029
Practice Address - Country:US
Practice Address - Phone:323-226-6937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117564207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine