Healthcare Provider Details

I. General information

NPI: 1902429483
Provider Name (Legal Business Name): PERRY LEE RABIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR EAST PAVILION G306
STANFORD CA
94305-5236
US

IV. Provider business mailing address

300 PASTEUR DR EAST PAVILION G306
STANFORD CA
94305-5236
US

V. Phone/Fax

Practice location:
  • Phone: 800-640-9255
  • Fax: 650-723-3780
Mailing address:
  • Phone: 800-640-9255
  • Fax: 650-723-3780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number205803
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number205803
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: