Provider Demographics
NPI:1295791838
Name:RAMBACHER, THOMAS E (DPM)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:RAMBACHER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28031 LUCERO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-4400
Mailing Address - Country:US
Mailing Address - Phone:949-637-0038
Mailing Address - Fax:949-916-1572
Practice Address - Street 1:28031 LUCERO
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-2622
Practice Address - Country:US
Practice Address - Phone:949-637-0038
Practice Address - Fax:949-916-1572
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4488213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU94654Medicare UPIN
CAE4488Medicare ID - Type UnspecifiedMEDICARE NUMBER