Provider Demographics
NPI:1578519203
Name:RIFKIN, DENA E (MD)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:E
Last Name:RIFKIN
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 1:9500 GILMAN DRIVE VA MEDICAL CENTER
Mailing Address - Street 2:9111H
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-9111
Mailing Address - Country:US
Mailing Address - Phone:617-699-8969
Mailing Address - Fax:
Practice Address - Street 1:9500 GILMAN DRIVE VA MEDICAL CENTER
Practice Address - Street 2:9111H
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-9111
Practice Address - Country:US
Practice Address - Phone:617-699-8969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224488207RN0300X
CAA 109186207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology