Provider Demographics
NPI:1922098789
Name:RATINOFF, DENNIS E
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:E
Last Name:RATINOFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 UNIVERSITY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2148
Mailing Address - Country:US
Mailing Address - Phone:650-329-1600
Mailing Address - Fax:650-329-8474
Practice Address - Street 1:725 UNIVERSITY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2148
Practice Address - Country:US
Practice Address - Phone:650-329-1600
Practice Address - Fax:650-329-8474
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4888G152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T09809Medicare UPIN
SD0048880Medicare ID - Type Unspecified
ZZZ30173ZMedicare ID - Type Unspecified