Provider Demographics
NPI:1720526502
Name:ROLANDO A. ATIGA, M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ROLANDO A. ATIGA, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:ATIGA FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ATIGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-695-4688
Mailing Address - Street 1:25405 HANCOCK AVENUE, STE. 105
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562
Mailing Address - Country:US
Mailing Address - Phone:951-695-4688
Mailing Address - Fax:951-695-4689
Practice Address - Street 1:25405 HANCOCK AVENUE
Practice Address - Street 2:STE. 105
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562
Practice Address - Country:US
Practice Address - Phone:951-695-4688
Practice Address - Fax:951-695-4689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78505207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty