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 is a Family Medicine Physician 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
Phone: (323) 662-7764
Fax: (323) 662-7714
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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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