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ALPINE CREEK AND PINE VALLEY FAMILY MEDICINE INC. NPI 1295819639


NPI Information

NPI: 1295819639
Provider Name: ALPINE CREEK AND PINE VALLEY FAMILY MEDICINE INC.
Classification: Neuromusculoskeletal Medicine & OMM - 204D00000X
Entity Type: Organization
Address:
1347 TAVERN RD STE 9
ALPINE, CA
ZIP 91901
Phone: (619) 445-0205
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ALPINE CREEK AND PINE VALLEY FAMILY MEDICINE INC. is a neuromusculoskeletal medicine omm in Alpine, CA. The provider is the Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. ALPINE CREEK AND PINE VALLEY FAMILY MEDICINE INC. NPI is 1295819639. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1347 TAVERN RD STE 9
ALPINE, CA
ZIP 91901-897
Phone: (619) 445-0205
Fax: (619) 659-0205

The provider's authorized official is James M Ricketts .
The authorized official title is Ceo and has the following contact phone number (619) 445-0204.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204D00000XNeuromusculoskeletal Medicine & OMM20A4384CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100AX43840MEDICAIDCALIFORNIA
2ZZZ48102ZOTHERCALIFORNIABLUE SHIELD
300AX62390MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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