DR. RODOLFO T. TABILA (NPI# 1962538181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962538181 |
| Entity Type | Individual |
| Full Name | DR. RODOLFO T. TABILA |
| Credential | M.D. |
| Practice Address |
1339 W Willow St Long Beach CA 90810-3116 |
| Practice Telephone | 5624926698 |
| Practice Fax Number | 5624929553 |
| Mailing Telephone | 5624926698 |
| Mailing Fax Number | 5624929553 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-03-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A38544 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A385440 | 05 | |
| CA | CLIA ID NO | 05D0973914 | 01 |
| CA | STATE LICENSE NO | A38544 | 01 |
| CA | CLIA ID NO | 05D0865425 | 01 |
| Street Address |
1339 W WILLOW ST |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90810-3116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720077852 | First Integrated Care Medical Group Inc | Family Medicine | 1339 W Willow St, Long Beach, CA 90810-3116 | 2005-10-20 |
| 1437595113 | Cheryl Chua Buncio | Nurse Practitioner | 1339 W Willow St, Long Beach, CA 90810-3116 | 2013-05-21 |
| 1619219730 | Claire Andrey Lezada Do | Nurse Practitioner | 1339 W Willow St, Long Beach, CA 90810-3116 | 2013-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013567262 | Arsenia Morante Ramos | Technician | 1928 W Lincoln Street, Long Beach, CA 90810 | 2019-09-18 |
| 1992263867 | Yesenia Llerenas | Counselor | Children's Institute Inc, 1500 Hughes Way #100, Long Beach, CA 90810 | 2019-03-08 |
| 1649746215 | Cassandra Whitney Dewey | Counselor | 2120 W. Williams Street, Long Beach, CA 90810 | 2018-10-22 |
| 1497204028 | Jose Carlos Garcia | Dental Assistant | 2636 E Dominguez St, Long Beach, CA 90810 | 2016-09-23 |
| 1255706560 | Sabrina Navarro | Rehabilitation Practitioner | 1501 Hughles Way, Suite 150, Long Beach, CA 90810 | 2015-12-11 |
| 1275917692 | The Childrens Clinic 'serving Children and Their Families' | Clinic/Center | 2000 San Gabriel Avenue, Long Beach, CA 90810 | 2015-07-15 |
| 1881932168 | Ronald Merton Sommer | Family Medicine | 1436 W. 23rd St., Westside Free Clinic, Long Beach, CA 90810 | 2013-01-22 |
| 1619241601 | Vander J. Dale Jr. | Counselor | 2090 River Avenue, Long Beach, CA 90810 | 2012-03-08 |
| 1205125606 | Maria Anna Castillo Tejada | Physical Therapist | 2679 N La Vere Dr, Long Beach, CA 90810 | 2011-04-06 |
| 1386973436 | Roosevelt Williams Jr. | Physical Therapy Assistant | 6444 East Spring St, # 247, Long Beach, CA 90810 | 2009-12-21 |
| Find all providers in zip 90810 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144852435 | Clnica Uriel / Iradj Nazarian Md | Family Medicine | 1187 E Anaheim St, Long Beach, CA 90813-3662 | 2020-02-05 |
| 1104485887 | Pmd Wellness Center Inc. | Family Medicine | Pmd Wellness Center Inc, 1187 E. Anaheim St., Long Beach, CA 90813-3663 | 2019-06-06 |
| 1699248674 | Central Neighborhood Health Foundat | Family Medicine | 711 E Via Wanda, Long Beach, CA 90805-6526 | 2019-01-02 |
| 1629580337 | Kathleen Legaspi Hoops | Family Medicine | 865 Lees Ave, Long Beach, CA 90815-5024 | 2017-11-02 |
| 1609222942 | Prohealth Partners A Medical Group | Family Medicine | 3816 Woodruff Ave Ste 406, Long Beach, CA 90808-2146 | 2016-05-05 |
| 1083079289 | Majestic Medical Clinic, Inc. | Family Medicine | 817 Atlantic Ave # 14, Long Beach, CA 90813-4512 | 2015-12-15 |
| 1336522788 | Duc Nguyen | Family Medicine | 555 E Ocean Blvd Ste 110, Long Beach, CA 90802 | 2015-07-02 |
| 1356781132 | Philip Kim | Family Medicine | 1729 Termino Ave Ste B, Long Beach, CA 90804-2121 | 2013-06-26 |
| 1881932168 | Ronald Merton Sommer | Family Medicine | 1436 W. 23rd St., Westside Free Clinic, Long Beach, CA 90810 | 2013-01-22 |
| 1053693275 | Michael James Miech | Family Medicine | 6301 Marina Pacifica Dr S, Long Beach, CA 90803-3821 | 2011-09-13 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90810 |
Please comment or provide details below to improve the information on DR. RODOLFO T. TABILA.
| 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.