Provider Demographics
NPI:1669513495
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:H
Authorized Official - Last Name:RASEKHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-203-5561
Mailing Address - Street 1:PO BOX 6208
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91734-6208
Mailing Address - Country:US
Mailing Address - Phone:626-575-7500
Mailing Address - Fax:626-575-1956
Practice Address - Street 1:12100 VALLEY BLVD
Practice Address - Street 2:SUITE #109A
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-3100
Practice Address - Country:US
Practice Address - Phone:626-575-7500
Practice Address - Fax:626-575-1956
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:R&B MEDICAL GROUP,INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-12
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51813207Q00000X, 207R00000X
CAA48861207QA0505X, 207R00000X, 207Q00000X
CAA53663207V00000X
CAA38055208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult 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
CAGR0063880Medicaid
W13393Medicare PIN