Basic Information
| Provider Information | |||||||||
| NPI: | 1396732855 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RATHOD | ||||||||
| FirstName: | RAMESH | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E VALENCIA MESA DR STE 206 | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928353817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144465050 | ||||||||
| FaxNumber: | 7144465150 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 E VALENCIA MESA DR STE 206 | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928353817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144465050 | ||||||||
| FaxNumber: | 7144465150 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2005 | ||||||||
| LastUpdateDate: | 10/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A33160 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | A33160 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.