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RUCKER MEDICAL GROUP INC NPI 1174801054


NPI Information

NPI: 1174801054
Provider Name: RUCKER MEDICAL GROUP INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
5265 FOUNTAIN AVE
SUITE 1A
LOS ANGELES, CA
ZIP 90029
Phone: (323) 662-7764
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RUCKER MEDICAL GROUP INC is a family medicine in Los Angeles, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. RUCKER MEDICAL GROUP INC NPI is 1174801054. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

5265 FOUNTAIN AVE
SUITE 1A
LOS ANGELES, CA
ZIP 90029-300
Phone: (323) 662-7764
Fax: (323) 662-7714

The provider's authorized official is Burnett Rucker .
The authorized official title is Medical Director and has the following contact phone number (323) 662-7764.

The enumeration date for this NPI number is 7/27/2011 and was last updated on 7/27/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineA34349CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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