Provider Demographics
NPI:1447590633
Name:JEFFREY S RINKOFF PROF CORP
Entity Type:Organization
Organization Name:JEFFREY S RINKOFF PROF CORP
Other - Org Name:RETINA CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-842-2020
Mailing Address - Street 1:2640 E BARNETT RD # 232
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4301
Mailing Address - Country:US
Mailing Address - Phone:541-842-2020
Mailing Address - Fax:541-842-2022
Practice Address - Street 1:110 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MOUNT SHASTA
Practice Address - State:CA
Practice Address - Zip Code:96067-2209
Practice Address - Country:US
Practice Address - Phone:541-842-2020
Practice Address - Fax:541-842-2022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50167207W00000X
CAA116614207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ24340ZMedicare PIN