Provider Demographics
NPI:1659974681
Name:GARY RINZLER MD PC A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:GARY RINZLER MD PC A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING AND BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAGANZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-855-9304
Mailing Address - Street 1:904 SILVER SPUR RD # 805
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3800
Mailing Address - Country:US
Mailing Address - Phone:530-848-7666
Mailing Address - Fax:562-262-2028
Practice Address - Street 1:790 E WILLOW ST STE 200
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2718
Practice Address - Country:US
Practice Address - Phone:530-848-2028
Practice Address - Fax:562-262-2028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-20
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty