Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A140439 | CA |
NPI | 1023308921 |
---|---|
Provider Name | Kathleen Dolores Rickert |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-4232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2011 |
Last Update Date | 22/06/2016 |