Provider Demographics
NPI:1861422578
Name:TALATI, ROHIN B (MD)
Entity type:Individual
Prefix:
First Name:ROHIN
Middle Name:B
Last Name:TALATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OCEANGATE #100
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4317
Mailing Address - Country:US
Mailing Address - Phone:562-499-6191
Mailing Address - Fax:562-499-6171
Practice Address - Street 1:1650 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-5824
Practice Address - Country:US
Practice Address - Phone:909-467-0797
Practice Address - Fax:909-391-1288
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46621207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A46621Medicaid
CAA00466210OtherMEDI-CAL
CAAQ815ZMedicare PIN
E78439Medicare UPIN
CAA0046621Medicare PIN
CAWA46621FMedicare PIN
CA00A46621Medicaid