Individual
DR. BRENT CHRISTOPHER 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) 380-2884
(209) 526-3908
Mailing address
1601 MCHENRY VILLAGE WAY STE 3, MODESTO, CA 95350-4338
(209) 380-2884
(209) 526-3908
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E 5055
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH008A
MEDICARE PTAN
CA
Enumeration date
06/30/2010
Last updated
07/09/2013
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