Organization
BRENT RIDDER, MD,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT W RIDDER MD (PRESIDENT)
(949) 206-4633
Entity
Organization
Contact information
Practice address
23961 CALLE DE LA MAGDALENA, #115, LAGUNA HILLS, CA 92653-3616
(949) 206-4633
(949) 855-2314
Mailing address
23961 CALLE DE LA MAGDALENA, #115, LAGUNA HILLS, CA 92653-3616
(949) 206-4633
(949) 855-2314
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
CA
Other
Enumeration date
09/17/2013
Last updated
09/17/2013
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