MEDICARE: JOHN RABIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	G83044	CA

General Provider Information

NPI Number	:	1124185442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN RABIN M.D.

Provider Business Mailing Address
First Line	:	11510 IMPERIAL HWY
Second Line	:
City	:	NORWALK
State	:	CA
Zip	:	90650-2801
Country	:	US
Telephone Number	:	310-721-7547
Fax Number	:	805-494-8385

Provider Business Practice Location Address
First Line	:	171 PIER AVE # 253
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-5311
Country	:	US
Telephone Number	:	310-721-7547
Fax Number	:	714-229-5785

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	10/14/2020

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