MEDICARE: DR. ALEX RAINOW MD

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	207RC0000X	Cardiovascular Disease Physician	C154306	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255577904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX RAINOW MD

Provider Business Mailing Address
First Line	:	2 BON AIR RD STE 100
Second Line	:
City	:	LARKSPUR
State	:	CA
Zip	:	94939-1144
Country	:	US
Telephone Number	:	415-927-0666
Fax Number	:	415-927-6159

Provider Business Practice Location Address
First Line	:	651 1ST ST W STE L
Second Line	:
City	:	SONOMA
State	:	CA
Zip	:	95476-7046
Country	:	US
Telephone Number	:	707-935-1470
Fax Number	:	707-935-7817

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

Provider Enumeration Date	:	12/31/2008
Last Update Date	:	07/27/2021

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