Provider Demographics
NPI:1881657559
Name:RHEE, JOON W (MD PHD MPH)
Entity Type:Individual
Prefix:
First Name:JOON
Middle Name:W
Last Name:RHEE
Suffix:
Gender:M
Credentials:MD PHD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34675 YUCAIPA BLVD
Mailing Address - Street 2:#102
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-4155
Mailing Address - Country:US
Mailing Address - Phone:909-790-4795
Mailing Address - Fax:909-790-4796
Practice Address - Street 1:34675 YUCAIPA BLVD
Practice Address - Street 2:#102
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-4155
Practice Address - Country:US
Practice Address - Phone:909-790-4795
Practice Address - Fax:909-790-4796
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77852207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I10541Medicare UPIN
CA00A778521Medicare ID - Type Unspecified