Active NPI
Horst R. Rudrich Medical Corporation
- Family Medicine Physician
- Redlands, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A5970
- Legal business name
- HORST R. RUDRICH MEDICAL CORPORATION
- Practice address
- 255 Terracina Blvd
Ste. 105
Redlands, CA 92373-4870 - Phone
- (909) 793-0323
- Fax
- (909) 793-9173
- NPI assigned
- Mar 25, 2008
- Last updated
- Mar 12, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Horst R Rudrich, D.O.
- Title
- Physician / President
- Phone
- (909) 798-3061
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A5970 | CA | Primary |
Addresses
Primary practice location
255 Terracina Blvd
Ste. 105
Redlands, CA 92373-4870
Mailing address
1574 Edgehill LN
Redlands, CA 92373-6523
Phone (909) 798-3061
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX59700 | Medicaid | CA | |
| 080190100 | Other | CA | MEDICARE RAILROAD |
| 020A59701 | Other | CA | MEDICARE ID |
National Provider Directory
National Provider DirectoryLocations
255 Terracina Blvd
Ste 105
Redlands, CA 92373
Phone (909) 793-0323
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Redlands, CA
- NPI 1053426957
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206403200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1426118400000",
"number": "1740452259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1574 EDGEHILL LN",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923736523",
"telephone_number": "909-798-3061",
"fax_number": "909-798-1221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 TERRACINA BLVD",
"address_2": "STE. 105",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923734870",
"telephone_number": "909-793-0323",
"fax_number": "909-793-9173"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HORST R. RUDRICH MEDICAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-25",
"last_updated": "2015-03-12",
"status": "A",
"authorized_official_last_name": "RUDRICH",
"authorized_official_first_name": "HORST",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "PHYSICIAN / PRESIDENT",
"authorized_official_telephone_number": "909-798-3061",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A5970",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX59700",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "080190100",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "020A59701",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.