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Individual
MICHAEL RICHARD DITTRICH
Active
Individual
MICHAEL RICHARD DITTRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
NP6056
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000810374542
PHCS
CA
01
—
1750289
GREAT WEST
CA
01
—
2688843
UNITED HEALTHCARE
CA
01
—
461131
INTERPLAN
CA
01
—
5843015
AETNA
CA
01
—
90207877
PACIFICARE
CA
01
—
N397509
BLUE CROSS
CA
05
—
RN397509
—
CA
Enumeration date
11/17/2006
Last updated
07/08/2007
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