Provider Demographics
NPI:1912329582
Name:ARTHRITIS AND RHEUMATIC DISEASE CENTER, INC.
Entity type:Organization
Organization Name:ARTHRITIS AND RHEUMATIC DISEASE CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHENK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-583-0222
Mailing Address - Street 1:24331 EL TORO RD
Mailing Address - Street 2:380
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-2752
Mailing Address - Country:US
Mailing Address - Phone:949-583-0222
Mailing Address - Fax:949-583-0252
Practice Address - Street 1:24331 EL TORO RD
Practice Address - Street 2:380
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-2752
Practice Address - Country:US
Practice Address - Phone:949-583-0222
Practice Address - Fax:949-583-0252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG046010207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA50264Medicare UPIN