BORWORN RATTIDHAM,MD.,P.C. (NPI# 1689865776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689865776 |
| Entity Type | Organization |
| Organization Name | BORWORN RATTIDHAM,MD.,P.C. |
| Practice Address |
126 Avocado Ave Ste 102 Perris CA 92571-2605 |
| Practice Telephone | 9519438110 |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |
| Authorized Official Name | DR. BORWORN RATTIDHAM (PRESIDENT) |
| Authorized Official Telephone | 9519438110 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
A25955 | CA | Ambulatory Health Care Facilities |
| Street Address |
126 AVOCADO AVE STE 102 |
| City | PERRIS |
| State | CA |
| Zip Code | 92571-2605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023560604 | Rapid Care Enterprises, Inc | Clinic/Center | 126 Avocado Ave Ste 102, Perris, CA 92571-2605 | 2016-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376199422 | Pico De Loro, Incorporated | Assisted Living Facility | 620 North Perris Boulevard, Perris, CA 92571 | 2019-08-14 |
| 1053802579 | Kadiatou Dafney | Nurse Practitioner | 126 Avocado Ave Ste 106, Perris, CA 92571 | 2018-05-21 |
| 1730677014 | Ruth Gasselle Rodriguez | Nutritionist | 1020 Huntington Way, Perris, CA 92571 | 2018-04-23 |
| 1649788167 | Leslie Bautista | Counselor | 1276 Autumnwood Ln, Perris, CA 92571 | 2018-01-18 |
| 1588180459 | Eduardo Orozco-zavala | Licensed Vocational Nurse | 85 Ramona Expressway, Suite 1, Perris, CA 92571 | 2017-08-22 |
| 1396267365 | National Vision, Inc. | Technician/Technologist | 1850 N Perris Boulevard, Suite 40, Perris, CA 92571 | 2017-07-12 |
| 1336669506 | Gary Huang | Optometrist | 1850 N Perris Boulevard Ste 40, Perris, CA 92571 | 2017-06-20 |
| 1750814745 | New Beginnings Residential Tf | Residential Treatment Facility, Emotionally Disturbed Children | 106 Worth St, Perris, CA 92571 | 2017-04-06 |
| 1013456235 | Sohal and Pham Dental Corporation | Dentist | 1820 Perris Blvd, Suite 70, Perris, CA 92571 | 2017-02-21 |
| 1093267569 | New Beginnings Residential Tf | Residential Treatment Facility, Emotionally Disturbed Children | 2464 Slew of Gold Ct, Perris, CA 92571 | 2016-10-31 |
| Find all providers in zip 92571 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.