Organization
PRESCOTT C. RASMUSSEN, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRESCOTT C RASMUSSEN MD (PRESIDENT)
(323) 725-4211
Entity
Organization
Contact information
Practice address
309 W BEVERLY BLVD, MONTEBELLO, CA 90640-4308
(323) 725-4211
Mailing address
PO BOX 10076, VAN NUYS, CA 91410-0076
(805) 578-8300
(805) 578-8950
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
G10130
CA
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G101300
BLUE SHIELD
CA
Enumeration date
03/24/2006
Last updated
08/22/2020
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