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General NPI Number Information
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NPI Number | 1578615480
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Entity Type | Individual
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Provider Name | RASOUL MOKABBERI MD
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 100 N ACADEMY AVE GEISINGER MEDICAL CENTER
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City | DANVILLE
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State | PA
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Zip | 17822-9800
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Country | US
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Telephone | 216-269-2654
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Fax | 570-271-1702
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Provider Business Mailing Address
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Address Line | 100 N ACADEMY AVE GEISINGER MEDICAL CENTER
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City | DANVILLE
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State | PA
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Zip | 17822-9800
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Country | US
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Telephone | 216-269-2654
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Fax | 570-271-1702
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35089082
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A 95258
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD 435510
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License Number State | PA
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