Provider Demographics
NPI:1437112851
Name:RAPPARD, GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:RAPPARD
Suffix:
Gender:M
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:PO BOX 80304
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91716-8304
Mailing Address - Country:US
Mailing Address - Phone:323-857-5300
Mailing Address - Fax:323-857-5300
Practice Address - Street 1:6200 WILSHIRE BLVD
Practice Address - Street 2:#806
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5801
Practice Address - Country:US
Practice Address - Phone:323-857-5300
Practice Address - Fax:323-857-5301
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA634192085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOA634190Medicaid
G70287Medicare UPIN
CAWA63419FMedicare ID - Type Unspecified
CAOOA634190Medicaid