Provider Demographics
NPI:1306885009
Name:RHEE, EUNICE N (DO)
Entity type:Individual
Prefix:DR
First Name:EUNICE
Middle Name:N
Last Name:RHEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 E ELDER ST
Mailing Address - Street 2:STE 104
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-3081
Mailing Address - Country:US
Mailing Address - Phone:760-728-9560
Mailing Address - Fax:760-728-9020
Practice Address - Street 1:521 E ELDER ST
Practice Address - Street 2:STE 104
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3081
Practice Address - Country:US
Practice Address - Phone:760-728-9560
Practice Address - Fax:760-728-9020
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036110777207R00000X
CA20A10812207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A10812OtherSTATE LIC
IL2221474OtherBCBS
IL036110777 2Medicaid
IL036110777Medicaid
IL2221474OtherBCBS
CA20A10812OtherSTATE LIC
ILR01262Medicare PIN
ILI22524Medicare UPIN
ILK13123Medicare ID - Type UnspecifiedDUPAGE