Healthcare Provider Details

I. General information

NPI: 1417141300
Provider Name (Legal Business Name): ALAN RASHKIN, M.D. A PROFESSIONAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 02/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 E LOS ANGELES AVE STE 203
SIMI VALLEY CA
93065-7839
US

IV. Provider business mailing address

1350 E LOS ANGELES AVE STE 203
SIMI VALLEY CA
93065-7839
US

V. Phone/Fax

Practice location:
  • Phone: 805-527-3222
  • Fax: 805-582-2651
Mailing address:
  • Phone: 805-572-3222
  • Fax: 805-582-2651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberG38481
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG38481
License Number StateCA

VIII. Authorized Official

Name: DR. ALAN RASHKIN
Title or Position: OWNER
Credential: MD
Phone: 805-527-3222