# THE CALIFORNIA INSTITUTE FOR AESTHETIC MEDICINE

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

## Provider details

- **NPI number:** 1508272337
- **Authorized official:** DR. P. SCOTT RICKE M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (858) 678-0220

## Contact information

- **Practice address:** 4150 REGENTS PARK ROW, SUITE 360, LA JOLLA, CA 92037-9124
- **Practice address phone:** (858) 678-0220
- **Mailing address:** 8875 COSTA VERDE BLVD, APT 407, SAN DIEGO, CA 92122-6656
- **Mailing address phone:** (858) 678-0220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | 37788 | CA | Yes |

## Other

- **Enumeration date:** 07/01/2014
- **Last updated:** 07/01/2014