Basic Information
Provider Information
NPI: 1417363086
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALKATIB
FirstName: RHONDA
MiddleName: EMILY
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: DEPT. 453 PO BOX 1000
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381480001
CountryCode: US
TelephoneNumber: 8285752625
FaxNumber: 8283502174
Practice Location
Address1: 2655 CAMINO DEL RIO N STE 425
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921081633
CountryCode: US
TelephoneNumber: 6192866687
FaxNumber: 6192866695
Other Information
ProviderEnumerationDate: 07/03/2014
LastUpdateDate: 05/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207K00000XA163910CAY Allopathic & Osteopathic PhysiciansAllergy & Immunology 

ID Information
IDTypeStateIssuerDescription
10014842005CA MEDICAID
CB34566001CAMEDICARE PTANOTHER


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