| Organization Name: | DAVID J RICKLES M.D. INC. |
| NPI Number: | 1225059488 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID J RICKLES (PRESIDENT) |
| Mailing Address: | 14608 Hawthorne Blvd Lawndale |
| State: | CA US |
| Postal Code: | 902601521 |
| Phone Number: | 3109784970 |
| Fax Number: | 3109788668 |
| NPI Enumeration Date: | 07/22/2006 |
| NPI Last Update Date: | 03/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0203X |
| License Number: | G56693 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Oncology, Radiation |
| Taxonomy Definition: | |