Brent Ridder, MD,Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BRENT RIDDER, MD,INC.

Practice address

23961 Calle de la Magdalena
#115
Laguna Hills, CA 92653-3616

Phone

(949) 206-4633

Fax

(949) 855-2314

NPI assigned

Sep 17, 2013

Last updated

Sep 17, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brent W Ridder, MDNPI 1730120163

Title

President

Phone

(949) 206-4633

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brent Ridder, M.D.

  • Family Medicine Physician
  • Laguna Hills, CA
  • NPI 1730120163
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1063848406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23961 CALLE DE LA MAGDALENA",
            "address_2": "#115",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533616",
            "telephone_number": "949-206-4633",
            "fax_number": "949-855-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23961 CALLE DE LA MAGDALENA",
            "address_2": "#115",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533616",
            "telephone_number": "949-206-4633",
            "fax_number": "949-855-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT RIDDER, MD,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "RIDDER",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-206-4633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.