Provider Demographics
NPI:1083818694
Name:RASSBACH, CAROLINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:RASSBACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 WELCH RD STE 100
Mailing Address - Street 2:GENERAL PEDIATRICS INPATIENT DIVISION
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1505
Mailing Address - Country:US
Mailing Address - Phone:650-725-8292
Mailing Address - Fax:650-498-5684
Practice Address - Street 1:725 WELCH RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1601
Practice Address - Country:US
Practice Address - Phone:650-725-8292
Practice Address - Fax:650-498-5684
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2010-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD035548208000000X
CAA111155208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
022271 C95OtherMEDICARE
VAE070107Medicaid
MD413146100Medicaid