# JUAN CARLOS RICAURTE MD INC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174753040
- **Authorized official:** DR. JUAN CARLOS RICAURTE M.D. (PRESIDENT)
- **Authorized official phone:** (626) 320-6303

## Contact information

- **Practice address:** 1300 NORTH VERMONT AVE, SUITE 806, LOS ANGELES, CA 90027-6302
- **Practice address phone:** (323) 663-6790
- **Practice address fax:** (323) 663-6791
- **Mailing address:** 1300 NORTH VERMONT AVE, SUITE 806, LOS ANGELES, CA 90027-6302
- **Mailing address phone:** (323) 663-6790
- **Mailing address fax:** (323) 663-6791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | A70169 | CA | Yes |

## Other

- **Enumeration date:** 07/24/2009
- **Last updated:** 09/25/2014