Provider Demographics
NPI:1215232301
Name:REGIONAL ASSOCIATES MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:REGIONAL ASSOCIATES MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAPANA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-801-0078
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-0457
Mailing Address - Country:US
Mailing Address - Phone:909-971-9334
Mailing Address - Fax:909-971-9654
Practice Address - Street 1:6505 ROSEMEAD BLVD
Practice Address - Street 2:STE 104E
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-3565
Practice Address - Country:US
Practice Address - Phone:562-801-0078
Practice Address - Fax:562-490-8589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty