=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316019060
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | R S MEDICAL INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2006
-----------------------------------------------------
Last Update Date | 03/12/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1101 PAJARO ST
-----------------------------------------------------
City | SALINAS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93901-2905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-758-6134
-----------------------------------------------------
Fax | 831-758-6136
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1101 PAJARO ST
-----------------------------------------------------
City | SALINAS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93901-2905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-758-6134
-----------------------------------------------------
Fax | 831-758-6136
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. RAVIN R SHARMA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 831-758-6134
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | A38663
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------