Provider Demographics
NPI:1831139815
Name:RABIN, BRADFORD COURTNEY (MD)
Entity Type:Individual
Prefix:
First Name:BRADFORD
Middle Name:COURTNEY
Last Name:RABIN
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 1:3200 MIDDLEFIELD ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306
Mailing Address - Country:US
Mailing Address - Phone:650-494-7004
Mailing Address - Fax:650-494-1282
Practice Address - Street 1:3200 MIDDLEFIELD ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306
Practice Address - Country:US
Practice Address - Phone:650-494-7004
Practice Address - Fax:650-494-1282
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71818207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H56633Medicare UPIN
00A718183Medicare ID - Type Unspecified