Provider Demographics
NPI:1821211673
Name:RODMAN CARA RITTER & INABA INC
Entity Type:Organization
Organization Name:RODMAN CARA RITTER & INABA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-737-8005
Mailing Address - Street 1:3010 W ORANGE AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3170
Mailing Address - Country:US
Mailing Address - Phone:714-772-4151
Mailing Address - Fax:714-252-0013
Practice Address - Street 1:3055 W ORANGE AVE STE 201
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3154
Practice Address - Country:US
Practice Address - Phone:714-772-4151
Practice Address - Fax:714-252-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA19929174400000X
CAG12514174400000X
CAG23113174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ74888ZMedicaid
CAZZZ74888ZMedicaid