=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821306838
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | T.R.RHEE,M.D.INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/24/2010
-----------------------------------------------------
Last Update Date | 10/07/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12555 GARDEN GROVE BLVD SUITE 408
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92843-1902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-530-1010
-----------------------------------------------------
Fax | 714-530-0215
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12555 GARDEN GROVE BLVD. SUITE 408
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92843-1902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-530-1010
-----------------------------------------------------
Fax | 714-530-0215
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. TAE RYANG RHEE
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 714-530-1010
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | A26795
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------