Provider Demographics
NPI:1114172095
Name:RICARTE, JOSEPH PILAR
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PILAR
Last Name:RICARTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5160 N MAYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1212
Mailing Address - Country:US
Mailing Address - Phone:323-253-0738
Mailing Address - Fax:
Practice Address - Street 1:14411 VANOWEN ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4038
Practice Address - Country:US
Practice Address - Phone:818-989-7475
Practice Address - Fax:818-781-3822
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner