Provider Demographics
NPI:1255471868
Name:R & R CLINICAL & MEDICAL CORP
Entity Type:Organization
Organization Name:R & R CLINICAL & MEDICAL CORP
Other - Org Name:CLINICA MEDICA NUESTRA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-398-0354
Mailing Address - Street 1:1403 N FAIR OAKS AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-1858
Mailing Address - Country:US
Mailing Address - Phone:626-398-0354
Mailing Address - Fax:626-398-0357
Practice Address - Street 1:1403 N FAIR OAKS AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1858
Practice Address - Country:US
Practice Address - Phone:626-398-0354
Practice Address - Fax:626-398-0357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56502207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A565020OtherINSURANCE
CAGR0100500Medicaid
CAGR0100500Medicaid
CA00A565020OtherINSURANCE
CAH39010Medicare UPIN