Organization
RASOULI MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GHOLAMREZA RASOULI MD (SOLE OWNER)
(909) 289-4906
Entity
Organization
Contact information
Practice address
2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404-4836
(909) 883-8711
Mailing address
700 E REDLANDS BLVD, STE U, # 361, REDLANDS, CA 92373-6143
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
A85426
CA
Other
Enumeration date
10/20/2007
Last updated
10/20/2007
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