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General NPI Number Information
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NPI Number | 1063728293
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Entity Type | Organization
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Legal Business Name | ALEX RABINOVICH, MD, INC
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 129 SACRAMENTO ST STE B
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-4001
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Country | US
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Telephone | 415-817-9991
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Fax | 415-901-0666
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Provider Business Mailing Address
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Address Line | 129 SACRAMENTO ST STE B
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-4001
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Country | US
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Telephone | 415-817-9991
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Fax | 415-901-0666
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEXANDER RABINOVICH
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Credential | DDS, MD
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Telephone | 415-935-3223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | 48850
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License Number State | CA
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