Organization Active NPI

Horst R. Rudrich Medical Corporation

  • Family Medicine Physician
  • Redlands, CA
National Provider Identifier
1740452259
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A5970 Issued in CA
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, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
Horst R Rudrich, D.O.NPI 1053426957
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00AX59700MedicaidCA
080190100OtherCAMEDICARE RAILROAD
020A59701OtherCAMEDICARE ID

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.