Provider Demographics
NPI:1700804986
Name:RUTH, RICHARD DIETER (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DIETER
Last Name:RUTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7851 WALKER ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1747
Mailing Address - Country:US
Mailing Address - Phone:714-390-0476
Mailing Address - Fax:714-690-1506
Practice Address - Street 1:7851 WALKER ST
Practice Address - Street 2:SUITE 104
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1747
Practice Address - Country:US
Practice Address - Phone:714-390-0476
Practice Address - Fax:714-690-1506
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85653207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine