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General NPI Number Information
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NPI Number | 1225415714
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Entity Type | Individual
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Provider Name | RIM ELCHAKI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/04/2015
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 1100 LARKSPUR LANDING CIR SUITE 10
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City | LARKSPUR
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State | CA
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Zip | 94939
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Country | US
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Telephone | 415-464-1350
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Fax |
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Provider Business Mailing Address
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Address Line | 1721 ANDOVER WAY
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City | PETALUMA
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State | CA
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Zip | 94954
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Country | US
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Telephone | 310-592-9304
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A154454
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | A154545
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License Number State | CA
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