Provider Demographics
NPI:1568541803
Name:RUTERBUSCH, VICTOR LINCOLN (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:LINCOLN
Last Name:RUTERBUSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 SEA VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:CARDIFF BY THE SEA
Mailing Address - State:CA
Mailing Address - Zip Code:92007-1440
Mailing Address - Country:US
Mailing Address - Phone:760-566-8836
Mailing Address - Fax:
Practice Address - Street 1:1340 SEA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CARDIFF BY THE SEA
Practice Address - State:CA
Practice Address - Zip Code:92007-1440
Practice Address - Country:US
Practice Address - Phone:760-566-8836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD151172084P0800X
CAC1345072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry