Provider Demographics
NPI:1144207671
Name:MEDICAL OFFICES OF ROBERT RUSHTON, INC.
Entity Type:Organization
Organization Name:MEDICAL OFFICES OF ROBERT RUSHTON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:RUSHTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-462-8603
Mailing Address - Street 1:844 S DORA ST
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-5711
Mailing Address - Country:US
Mailing Address - Phone:707-462-8603
Mailing Address - Fax:707-462-8605
Practice Address - Street 1:844 S DORA ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5711
Practice Address - Country:US
Practice Address - Phone:707-462-8603
Practice Address - Fax:707-462-8605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM03969FMedicaid
CARHM03969FMedicaid
CA00G470550Medicare ID - Type Unspecified
CAZZZ23870ZMedicare ID - Type Unspecified