1184611220 NPI number — DR. MICHAEL JONATHAN RINGER MD

Table of content: SUMMER YANCER (NPI 1487303061)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184611220 NPI number — DR. MICHAEL JONATHAN RINGER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RINGER
Provider First Name:
MICHAEL
Provider Middle Name:
JONATHAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184611220
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1541 FLORIDA AVE
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
MODESTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95350-4429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-577-3388
Provider Business Mailing Address Fax Number:
209-523-0764

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1541 FLORIDA AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
MODESTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95350-4429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-577-3388
Provider Business Practice Location Address Fax Number:
209-523-0764
Provider Enumeration Date:
10/04/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  G15823 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CD237Z . This is a "INDIVIDUAL PTAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: CD069A . This is a "GROUP PTAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 110065381 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZZ48224Z . This is a "MEDICARE IDENTIFICATION #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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