Provider Demographics
NPI:1295763597
Name:RINEHART, KRISTOPHER R (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTOPHER
Middle Name:R
Last Name:RINEHART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660579
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91066-0579
Mailing Address - Country:US
Mailing Address - Phone:626-447-0296
Mailing Address - Fax:626-447-6057
Practice Address - Street 1:300 W HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3402
Practice Address - Country:US
Practice Address - Phone:626-574-3456
Practice Address - Fax:626-821-6927
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80354207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A803540Medicaid
CA00A803543Medicare PIN
CAWA80354PMedicare PIN
CAH99387Medicare UPIN
CA00A803540Medicaid
CA00A803541Medicare PIN
CA00A803540Medicare PIN
CA00A80354LMedicare PIN
CAWA80354MMedicare PIN