Individual
DR. MARVIN DARYLE RICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1601 MCHENRY VILLAGE WAY STE 3, MODESTO, CA 95350-4338
(209) 526-3907
(209) 526-3908
Mailing address
1601 MCHENRY VILLAGE WAY STE 3, MODESTO, CA 95350-4338
(209) 526-3907
(209) 526-3908
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2454
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E24540
—
CA
05
—
000E24541
—
CA
Enumeration date
07/05/2006
Last updated
07/08/2007
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