# ALPINE CREEK AND PINE VALLEY FAMILY MEDICINE INC.

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

## Provider details

- **NPI number:** 1295819639
- **Authorized official:** JAMES M RICKETTS D.O. (CEO)
- **Authorized official phone:** (619) 445-0204

## Contact information

- **Practice address:** 1347 TAVERN RD STE 9, ALPINE, CA 91901-3897
- **Practice address phone:** (619) 445-0205
- **Practice address fax:** (619) 659-0205
- **Mailing address:** 1347 TAVERN RD STE 9, ALPINE, CA 91901-3897
- **Mailing address phone:** (619) 445-0205
- **Mailing address fax:** (619) 659-0205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 20A4384 | CA | Yes |

## Other

- **Enumeration date:** 10/24/2006
- **Last updated:** 08/22/2020