Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Rucker Medical Group Inc

Organization Family Medicine Physician · NPI 1174801054

Rucker Medical Group Inc provides Family Medicine Physician services in Los Angeles, California. Licensed in California. Registered with an NPI since 2011.

Licensed in
CA
In the registry since
2011
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5265 Fountain Ave Ste 1A
Los Angeles, CA 90029-1300 Not confirmed with CMS for 15 years — call before visiting
Phone: (323) 662-7764
Fax: (323) 662-7714
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A34349 (CA)

Record details

NPI number1174801054
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Burnett Rucker — Medical Director · (323) 662-7764
NPI enumeratedJuly 27, 2011
Last updated in NPPESJuly 27, 2011
Mailing address5265 Fountain Ave, Suite 1a, Los Angeles, CA 90029-1300

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