Individual
DR. TINA RUTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1408 E BARNETT RD, MEDFORD, OR 97504-8279
(541) 779-2020
(541) 770-6838
Mailing address
1408 E BARNETT RD, MEDFORD, OR 97504-8279
(541) 779-2020
(541) 770-6838
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
A89466
CA
207W00000X
Ophthalmology Physician
MD160057
OR
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
MD160057
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00894660
MEDI-CAL PPIN #
CA
01
—
A89466
LICENSE #
CA
Enumeration date
03/14/2007
Last updated
09/18/2020
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