MEDICARE: RT MED GROUP

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
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1922506716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RT MED GROUP

Provider Business Mailing Address
First Line	:	2120 W 8TH ST STE 103
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-4081
Country	:	US
Telephone Number	:	213-263-2143
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 W 8TH ST STE 103
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-4081
Country	:	US
Telephone Number	:	213-263-2143
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MIHWA BANG
Credential	:
Telephone Number	:	213-263-2143

Provider Enumeration Date	:	01/26/2018
Last Update Date	:	01/26/2018

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Directions to “RT MED GROUP ” Practice Location

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