Provider Demographics
NPI:1558398362
Name:RHEE, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:RHEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6102
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-6102
Mailing Address - Country:US
Mailing Address - Phone:415-884-3404
Mailing Address - Fax:415-883-1836
Practice Address - Street 1:3700 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1618
Practice Address - Country:US
Practice Address - Phone:415-750-6025
Practice Address - Fax:415-883-8082
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA560042085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00480245OtherRAILROAD MEDICARE
CA00A560040Medicaid
CA00A560048Medicare PIN
CAP00480245OtherRAILROAD MEDICARE
CAG91472Medicare UPIN
CA00A560049Medicare PIN
CADS750ZMedicare PIN
CA00A5600410Medicare PIN
CA00A560040Medicare PIN
CA00A560045Medicare PIN
CA00A560019Medicare PIN
CA00A560042Medicare PIN
CA00A560040Medicaid
CA00A5600424Medicare PIN
CA00A560043Medicare PIN
CA00A560046Medicare PIN