# RASOULI MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053500561
- **Authorized official:** DR. GHOLAMREZA RASOULI MD (SOLE OWNER)
- **Authorized official phone:** (909) 289-4906

## Contact information

- **Practice address:** 2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404-4836
- **Practice address phone:** (909) 883-8711
- **Mailing address:** 700 E REDLANDS BLVD, STE U, \# 361, REDLANDS, CA 92373-6143

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | A85426 | CA | Yes |

## Other

- **Enumeration date:** 10/20/2007
- **Last updated:** 10/20/2007