Provider Demographics
NPI:1336203918
Name:MARVIN A. RAWITCH MD FACR INC.
Entity Type:Organization
Organization Name:MARVIN A. RAWITCH MD FACR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:RAWITCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-855-8565
Mailing Address - Street 1:24100 EL TORO RD STE D
Mailing Address - Street 2:69
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-3129
Mailing Address - Country:US
Mailing Address - Phone:949-855-8565
Mailing Address - Fax:949-859-0532
Practice Address - Street 1:24100 EL TORO RD STE D
Practice Address - Street 2:69
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-3129
Practice Address - Country:US
Practice Address - Phone:949-855-8565
Practice Address - Fax:949-859-0532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41842085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty