Provider Demographics
NPI:1508055138
Name:MARFATIA, RINA S (MBBS, MD)
Entity Type:Individual
Prefix:DR
First Name:RINA
Middle Name:S
Last Name:MARFATIA
Suffix:
Gender:F
Credentials:MBBS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 S ELISEO DR
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2017
Mailing Address - Country:US
Mailing Address - Phone:415-795-7000
Mailing Address - Fax:
Practice Address - Street 1:1100 S ELISEO DR
Practice Address - Street 2:SUITE 2A
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2017
Practice Address - Country:US
Practice Address - Phone:415-795-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1101207RI0200X
CAA118206207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX287298801Medicaid
TX8DB346OtherBCBS
TX287298801Medicaid