1821211673 NPI number — RODMAN CARA RITTER & INABA INC

Table of content: (NPI 1821211673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821211673 NPI number — RODMAN CARA RITTER & INABA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RODMAN CARA RITTER & INABA INC
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:
1821211673
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3010 W ORANGE AVE STE 109
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANAHEIM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92804-3170
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-772-4151
Provider Business Mailing Address Fax Number:
714-252-0013

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3055 W ORANGE AVE STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANAHEIM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92804-3154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-772-4151
Provider Business Practice Location Address Fax Number:
714-252-0013
Provider Enumeration Date:
04/10/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CORONA
Authorized Official First Name:
BLANCA
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
714-737-8005

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  A19929 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: G12514 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: G23113 , 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: ZZZ74888Z , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".