Provider Demographics
NPI:1295137602
Name:ZHANNA RAPOPORT, MD, INC.
Entity type:Organization
Organization Name:ZHANNA RAPOPORT, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPOPORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-371-1067
Mailing Address - Street 1:3443 KENTUCKY LN
Mailing Address - Street 2:C/O TOVA KLEIN
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-8844
Mailing Address - Country:US
Mailing Address - Phone:951-371-1067
Mailing Address - Fax:951-808-5975
Practice Address - Street 1:7677 CENTER AVE
Practice Address - Street 2:STE 200
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3074
Practice Address - Country:US
Practice Address - Phone:714-952-0744
Practice Address - Fax:714-952-1405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG760352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty