Basic Information
| Provider Information | |||||||||
| NPI: | 1174807424 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RITE MEDICAL CLINIC INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 502 W HOLT AVE | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917683604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9096208500 | ||||||||
| FaxNumber: | 9096205799 | ||||||||
| Practice Location | |||||||||
| Address1: | 502 W HOLT AVE | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917683604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9096205699 | ||||||||
| FaxNumber: | 9096205799 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2011 | ||||||||
| LastUpdateDate: | 07/25/2014 | ||||||||
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| AuthorizedOfficialLastName: | POOYANDEH | ||||||||
| AuthorizedOfficialFirstName: | RASOUL | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9096208500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 27512 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor | 208100000X | A106704 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208D00000X | A106704 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.