Healthcare Provider Details

I. General information

NPI: 1407875123
Provider Name (Legal Business Name): HERBERT I RAPPAPORT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15342 HAWTHORNE BLVD
LAWNDALE CA
90260
US

IV. Provider business mailing address

15342 HAWTHORNE BLVD
LAWNDALE CA
90260-2152
US

V. Phone/Fax

Practice location:
  • Phone: 310-644-8400
  • Fax: 310-644-8424
Mailing address:
  • Phone: 310-644-8400
  • Fax: 310-644-8424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberG10471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: