1548323769 NPI number — DR. JAMES I RHO M.D.

Table of content: DR. JAMES I RHO M.D. (NPI 1548323769)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548323769 NPI number — DR. JAMES I RHO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RHO
Provider First Name:
JAMES
Provider Middle Name:
I
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548323769
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P O BOX 11238
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN BERNARDINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92423-1238
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-758-0411
Provider Business Mailing Address Fax Number:
909-758-0711

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9327 FAIRWAY VIEW PL
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
RANCHO CUCAMONGA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91730-0968
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-758-0411
Provider Business Practice Location Address Fax Number:
909-758-0711
Provider Enumeration Date:
12/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208VP0014X , with the licence number:  G80002 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 361322601 . This is a "ACS US DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: G80002 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 330859420 . This is a "BLUE CROSS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 720000260 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00G800020 . This is a "BLUE SHIELD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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