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Individual

MR. JUAN CARLOS RICAURTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
070169
CA
207RI0200X
Infectious Disease Physician
A701690
CA

Other

Enumeration date
10/13/2005
Last updated
10/07/2014
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