Provider Demographics
NPI:1952344624
Name:RITTER, BRUCE A (OD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:A
Last Name:RITTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:300 N BRAND BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2304
Mailing Address - Country:US
Mailing Address - Phone:209-951-3937
Mailing Address - Fax:209-477-2406
Practice Address - Street 1:300 N BRAND BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2304
Practice Address - Country:US
Practice Address - Phone:209-951-3937
Practice Address - Fax:209-477-2406
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8571T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist