Provider Demographics
NPI:1942478631
Name:C, ROSE RABINOV, M.D., INC
Entity Type:Organization
Organization Name:C, ROSE RABINOV, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:C. ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:RABINOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-323-1947
Mailing Address - Street 1:3545 SAN DIMAS ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1605
Mailing Address - Country:US
Mailing Address - Phone:661-323-1947
Mailing Address - Fax:661-323-1904
Practice Address - Street 1:3545 SAN DIMAS ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1660
Practice Address - Country:US
Practice Address - Phone:661-323-1947
Practice Address - Fax:661-323-1904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70060207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1891728739OtherOLD NPI
CAZZZ06919ZMedicare PIN
CAG23314Medicare UPIN