1801071964 NPI number — RSG MEDICAL CLINIC AND PSYCHOLOGICAL SERVICES

Table of content: (NPI 1801071964)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801071964 NPI number — RSG MEDICAL CLINIC AND PSYCHOLOGICAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RSG MEDICAL CLINIC AND PSYCHOLOGICAL SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1801071964
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MAYOMBO DISTRICT
Provider Second Line Business Mailing Address:
SUITE # 1010 MEDICAL ARTS TOWER, DDVMH
Provider Business Mailing Address City Name:
DAGUPAN
Provider Business Mailing Address State Name:
PANGASINAN
Provider Business Mailing Address Postal Code:
2400
Provider Business Mailing Address Country Code:
PH
Provider Business Mailing Address Telephone Number:
63755152058
Provider Business Mailing Address Fax Number:
63755158030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MAYOMBO DISTRICT
Provider Second Line Business Practice Location Address:
SUITE # 1010 MEDICAL ARTS TOWER, DDVMH
Provider Business Practice Location Address City Name:
DAGUPAN
Provider Business Practice Location Address State Name:
PANGASINAN
Provider Business Practice Location Address Postal Code:
2400
Provider Business Practice Location Address Country Code:
PH
Provider Business Practice Location Address Telephone Number:
63755152058
Provider Business Practice Location Address Fax Number:
63755158030
Provider Enumeration Date:
01/08/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GUANZON
Authorized Official First Name:
RICARDO
Authorized Official Middle Name:
SOTELO
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
63755152058

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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