Provider Demographics
NPI:1497844088
Name:RABINOWITZ, SAMUEL C (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:C
Last Name:RABINOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SAMUEL
Other - Middle Name:CHAIN
Other - Last Name:RABINOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:475 BRUCE ST
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-3474
Mailing Address - Country:US
Mailing Address - Phone:530-842-3507
Mailing Address - Fax:530-842-9121
Practice Address - Street 1:475 BRUCE ST
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-3474
Practice Address - Country:US
Practice Address - Phone:530-842-3507
Practice Address - Fax:530-842-9121
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45651207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE97966Medicare UPIN
CAWA45651DMedicare ID - Type Unspecified