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General NPI Number Information
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NPI Number | 1760623458
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Entity Type | Organization
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Legal Business Name | RITA R. ARCHER, M.D., INC.
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Dates
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Enumeration Date | 03/10/2009
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Last Update Date | 03/10/2009
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Provider Practice Location Address
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Address Line | 19582 BEACH BLVD STE 219
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-5923
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Country | US
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Telephone | 714-378-5147
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Fax | 714-968-4759
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Provider Business Mailing Address
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Address Line | 19582 BEACH BLVD STE 219
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-5923
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Country | US
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Telephone | 714-378-5147
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Fax | 714-968-4759
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RITA R ARCHER
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Credential | M.D.
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Telephone | 714-378-5147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | G85459
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License Number State | CA
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