Provider Demographics
NPI:1528374386
Name:RR OFFICE INC
Entity Type:Organization
Organization Name:RR OFFICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECYOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HYOSONG
Authorized Official - Middle Name:D
Authorized Official - Last Name:PANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-684-3598
Mailing Address - Street 1:15218 SUMMIT AVE
Mailing Address - Street 2:#255
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-0232
Mailing Address - Country:US
Mailing Address - Phone:909-684-3598
Mailing Address - Fax:
Practice Address - Street 1:1800 MEDICAL CENTER DR
Practice Address - Street 2:#300
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92411-1218
Practice Address - Country:US
Practice Address - Phone:909-684-3598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
G66421207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAED134AMedicare PIN