Provider Demographics
NPI:1346544228
Name:RDT ENTERPRISES INC.
Entity Type:Organization
Organization Name:RDT ENTERPRISES INC.
Other - Org Name:CORNERSTONE SPINE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TIMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-600-8024
Mailing Address - Street 1:27798 CANYON HILLS WAY
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-5093
Mailing Address - Country:US
Mailing Address - Phone:951-600-8024
Mailing Address - Fax:
Practice Address - Street 1:41555 CHERRY ST
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6402
Practice Address - Country:US
Practice Address - Phone:951-600-8024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26157111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0261570Medicare PIN