Provider Demographics
NPI:1083882567
Name:JOHN A. RABIN, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JOHN A. RABIN, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RABIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-721-7547
Mailing Address - Street 1:171 PIER AVE # 253
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-5311
Mailing Address - Country:US
Mailing Address - Phone:310-721-7547
Mailing Address - Fax:714-229-5785
Practice Address - Street 1:3055 W ORANGE AVE STE 206
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3154
Practice Address - Country:US
Practice Address - Phone:310-721-7547
Practice Address - Fax:714-229-5785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG830442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW22228Medicare PIN
CAH33537Medicare UPIN