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General NPI Number Information
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NPI Number | 1063798940
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Entity Type | Organization
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Legal Business Name | RIMON ISSAC D.O. INC
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Dates
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Enumeration Date | 10/24/2011
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 18 NINESTONE CT
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City | SAN RAFAEL
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State | CA
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Zip | 94903
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Country | US
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Telephone | 415-472-3730
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Fax |
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Provider Business Mailing Address
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Address Line | 18 NINESTONE CT
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City | SAN RAFAEL
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State | CA
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Zip | 94903
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS RIMON ISSAC
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Credential | D.O.
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Telephone | 415-472-3730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A5377
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License Number State | CA
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