MEDICARE: RAPEPORT MEDICAL CORPORATION

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	207RI0011X	Interventional Cardiology Physician

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861494601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAPEPORT MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	9850 GENESEE AVE
Second Line	:	STE 940B
City	:	LA JOLLA
State	:	CA
Zip	:	92037-1224
Country	:	US
Telephone Number	:	858-864-1400
Fax Number	:	619-668-1554

Provider Business Practice Location Address
First Line	:	9850 GENESEE AVE
Second Line	:	STE 940B
City	:	LA JOLLA
State	:	CA
Zip	:	92037-1224
Country	:	US
Telephone Number	:	858-864-1400
Fax Number	:	619-668-1554

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KEVIN B RAPEPORT
Credential	:	MD
Telephone Number	:	858-864-1400

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	12/14/2016

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Directions to “RAPEPORT MEDICAL CORPORATION ” Practice Location

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