| Organization Name: | ALPINE CREEK AND PINE VALLEY FAMILY MEDICINE INC. |
| NPI Number: | 1295819639 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES M RICKETTS (CEO) |
| Mailing Address: | 1347 Tavern Rd Ste 9 Alpine |
| State: | CA US |
| Postal Code: | 919013897 |
| Phone Number: | 6194450205 |
| Fax Number: | 6196590205 |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 20A4384 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |