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General NPI Number Information
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NPI Number | 1346544228
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Entity Type | Organization
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Legal Business Name | RDT ENTERPRISES INC.
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Dates
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Enumeration Date | 01/06/2011
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 41555 CHERRY ST
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City | MURRIETA
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State | CA
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Zip | 92562-6402
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Country | US
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Telephone | 951-600-8024
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Fax |
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Provider Business Mailing Address
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Address Line | 27798 CANYON HILLS WAY
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City | MURRIETA
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State | CA
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Zip | 92563-5093
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Country | US
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Telephone | 951-600-8024
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | CYNTHIA L TIMAR
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Credential |
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Telephone | 951-600-8024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | DC26157
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License Number State | CA
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