Provider Demographics
NPI:1033355730
Name:DONALD B. RHODES
Entity Type:Organization
Organization Name:DONALD B. RHODES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:B
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:530-222-2500
Mailing Address - Street 1:3753 CHURN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-2923
Mailing Address - Country:US
Mailing Address - Phone:530-222-2500
Mailing Address - Fax:530-222-2311
Practice Address - Street 1:3753 CHURN CREEK RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2923
Practice Address - Country:US
Practice Address - Phone:530-222-2500
Practice Address - Fax:530-222-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
152W00000X
CA4964T332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0049640Medicaid
CASD0049640Medicaid
CASD0049640Medicare PIN