Provider Demographics
NPI:1366639486
Name:RAB MEDICAL MANAGEMENT SERVICES, INC.
Entity Type:Organization
Organization Name:RAB MEDICAL MANAGEMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KWAME
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROBBEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-444-2171
Mailing Address - Street 1:366 S LEMON AVE
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2732
Mailing Address - Country:US
Mailing Address - Phone:909-444-2171
Mailing Address - Fax:909-444-2161
Practice Address - Street 1:366 S LEMON AVE
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-2732
Practice Address - Country:US
Practice Address - Phone:909-444-2171
Practice Address - Fax:909-444-2161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103768332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5338900001Medicare NSC