Provider Demographics
NPI:1245474501
Name:RUSHING, RONNIE GERALD II
Entity type:Individual
Prefix:MR
First Name:RONNIE
Middle Name:GERALD
Last Name:RUSHING
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5634 1/2 EDGEMAR AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-2800
Mailing Address - Country:US
Mailing Address - Phone:310-382-7410
Mailing Address - Fax:
Practice Address - Street 1:5634 1/2 EDGEMAR AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-2800
Practice Address - Country:US
Practice Address - Phone:310-382-7410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner