Organization Active NPI

Robert S. Herrick M.D. Inc

  • Ophthalmology Physician
  • Rialto, CA
National Provider Identifier
1477854123
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C24395 Issued in CA
Legal business name
ROBERT S. HERRICK M.D. INC
Practice address
882 W Rialto Ave
Rialto, CA 92376-5658
Phone
(909) 820-4051
Fax
(909) 820-4053
NPI assigned
Nov 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert Stuart Herrick, M.D.
Title
Ophthalmogist
Phone
(909) 820-4051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X C24395 CA Primary

Addresses

Primary practice location

882 W Rialto Ave
Rialto, CA 92376-5658

Mailing address

882 W Rialto Ave
Rialto, CA 92376-5658
Phone (909) 820-4051

Other identifiers 1

IdentifierTypeStateIssuer
C24395MedicaidCA

National Provider Directory

National Provider Directory

Locations

882 W Rialto Ave
Rialto, CA 92376
Phone (909) 820-4051

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1477854123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 W RIALTO AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765658",
            "telephone_number": "909-820-4051",
            "fax_number": "909-820-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 W RIALTO AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765658",
            "telephone_number": "909-820-4051",
            "fax_number": "909-820-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT S. HERRICK M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-11",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "HERRICK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "OPHTHALMOGIST",
        "authorized_official_telephone_number": "909-820-4051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C24395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C24395",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.