Provider Demographics
NPI:1174807424
Name:RITE MEDICAL CLINIC INC
Entity type:Organization
Organization Name:RITE MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RASOUL
Authorized Official - Middle Name:
Authorized Official - Last Name:POOYANDEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-620-8500
Mailing Address - Street 1:502 W HOLT AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-3604
Mailing Address - Country:US
Mailing Address - Phone:909-620-8500
Mailing Address - Fax:909-620-5799
Practice Address - Street 1:502 W HOLT AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-3604
Practice Address - Country:US
Practice Address - Phone:909-620-5699
Practice Address - Fax:909-620-5799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-05
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27512111N00000X
CAA106704208100000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty