Provider Demographics
NPI:1538143029
Name:RABE, MARIA CONCEPCION (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CONCEPCION
Last Name:RABE
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:PO BOX 60790
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91116-6790
Mailing Address - Country:US
Mailing Address - Phone:818-845-6206
Mailing Address - Fax:626-396-0851
Practice Address - Street 1:15248 11TH ST
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3704
Practice Address - Country:US
Practice Address - Phone:760-245-8691
Practice Address - Fax:760-843-6050
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89611207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A896110OtherBS OF CA
CA00A896110Medicaid
CA00A896111Medicare PIN
CA00A896110Medicaid
CAAS702YMedicare PIN
I45770Medicare UPIN