=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386968352
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RA CONSULTING GROUP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2010
-----------------------------------------------------
Last Update Date | 01/23/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12188 CENTRAL AVE SUITE #132
-----------------------------------------------------
City | CHINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91710-2420
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-575-8889
-----------------------------------------------------
Fax | 909-680-3143
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12188 CENTRAL AVE SUITE #132
-----------------------------------------------------
City | CHINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91710-2420
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-575-8889
-----------------------------------------------------
Fax | 909-680-3143
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. RAYMOND ABRAM
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 877-575-8889
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 247000000X
-----------------------------------------------------
Taxonomy Name | Health Information Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------