Provider Demographics
NPI:1528100336
Name:R&B MEDICAL GROUP,INC
Entity type:Organization
Organization Name:R&B MEDICAL GROUP,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RASEKHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-203-5561
Mailing Address - Street 1:27 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2364
Mailing Address - Country:US
Mailing Address - Phone:844-826-8274
Mailing Address - Fax:844-826-8274
Practice Address - Street 1:6700 VALJEAN AVE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406
Practice Address - Country:US
Practice Address - Phone:844-826-8274
Practice Address - Fax:949-783-5302
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:R&M MEDICAL GROUP,INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-12
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0063881Medicaid
CAW13393Medicare PIN