Provider Demographics
NPI:1225739147
Name:RJMRST PROFESSIONAL CORP
Entity Type:Organization
Organization Name:RJMRST PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANANGER
Authorized Official - Prefix:
Authorized Official - First Name:SUNANDA (SUE)
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-865-0263
Mailing Address - Street 1:1141 W REDONDO BEACH BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-3583
Mailing Address - Country:US
Mailing Address - Phone:714-865-0263
Mailing Address - Fax:909-563-1355
Practice Address - Street 1:1141 W REDONDO BEACH BLVD STE 306
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3583
Practice Address - Country:US
Practice Address - Phone:714-865-0263
Practice Address - Fax:909-563-1355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty