Provider Demographics
NPI:1386713931
Name:RITU MEISTER MD INC
Entity type:Organization
Organization Name:RITU MEISTER MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-476-4200
Mailing Address - Street 1:1595 SOQUEL DR
Mailing Address - Street 2:STE, 220
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1719
Mailing Address - Country:US
Mailing Address - Phone:831-476-4200
Mailing Address - Fax:831-476-5052
Practice Address - Street 1:1595 SOQUEL DR
Practice Address - Street 2:STE, 220
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1719
Practice Address - Country:US
Practice Address - Phone:831-476-4200
Practice Address - Fax:831-476-5052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG076326207V00000X
CAA030369207V00000X
CAG076064207V00000X
CA20A7123207V00000X
CA1405367A00000X
CA1712367A00000X
CA1566367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ49202ZOtherBLUE SHIELD GROUP ID
CAGR0077100Medicaid
CAZZZ49202ZOtherBLUE SHIELD GROUP ID