Healthcare Provider Details
I. General information
NPI: 1982920500
Provider Name (Legal Business Name): RMVR 8 INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/08/2010
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6508 LONETREE BLVD SUITE 103
ROCKLIN CA
95765-5885
US
IV. Provider business mailing address
6508 LONETREE BLVD SUITE 103
ROCKLIN CA
95765-5885
US
V. Phone/Fax
- Phone: 916-771-5533
- Fax:
- Phone: 916-771-5533
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | A89166 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
RAOUL
DEL MAR
Title or Position: CEO
Credential: MD
Phone: 916-771-5533