Provider Demographics
NPI:1053473785
Name:DRUMMOND, RITA KARTINI (OD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:KARTINI
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2545 FAIRGLEN PL
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-6613
Mailing Address - Country:US
Mailing Address - Phone:951-735-3387
Mailing Address - Fax:951-735-3387
Practice Address - Street 1:12700 DAY ST
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-7521
Practice Address - Country:US
Practice Address - Phone:951-656-6676
Practice Address - Fax:951-656-6676
Is Sole Proprietor?:No
Enumeration Date:2006-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11058T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist