Provider Demographics
NPI:1952388662
Name:RITCHEY, ROBERT PHILLIP (PAC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PHILLIP
Last Name:RITCHEY
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-4217
Mailing Address - Country:US
Mailing Address - Phone:530-673-9420
Mailing Address - Fax:530-673-9451
Practice Address - Street 1:1000 SUTTER ST
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3459
Practice Address - Country:US
Practice Address - Phone:530-673-9420
Practice Address - Fax:530-613-9451
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADF029YMedicare PIN
P85340Medicare UPIN
CAW9293EMedicare PIN
CADF029XMedicare PIN
CAW9293Medicare PIN
CAZZZ85361ZMedicare PIN