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NPI Code Detail

MEDICARE: RHONDA ROCHEE LUSTER MD

MEDICARE: RHONDA ROCHEE LUSTER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianG76910CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01363676OTHERCARAILROAD MEDICARE-DS9933
2P01363693OTHERCARAILROAD MEDICARE-DU4034
3P01363660OTHERCARAILROAD MEDICARE-DU4032
5P01453387-DV5277OTHERCARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
400G769100OTHERCAMEDI CAL

General Provider Information

NPI Number : 1255338406
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHONDA ROCHEE LUSTER MD
Provider Business Mailing Address
First Line : 625 FAIR OAKS AVE STE 270
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-5801
Country : US
Telephone Number : 626-346-2455
Fax Number : 626-639-3005
Provider Business Practice Location Address
First Line : 1900 ATLANTIC AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-5502
Country : US
Telephone Number : 562-591-8676
Fax Number : 877-469-3631
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2005
Last Update Date : 05/07/2018

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Directions to “ RHONDA ROCHEE LUSTER MD” Practice Location

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