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General NPI Number Information
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NPI Number | 1609011394
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Entity Type | Organization
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Legal Business Name | PAC LAP INC
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 12/09/2008
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Provider Practice Location Address
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Address Line | 2250 HAYES ST THIRD FLOOR
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-1078
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Country | US
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Telephone | 415-668-3200
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Fax | 415-668-2010
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Provider Business Mailing Address
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Address Line | 2250 HAYES ST THIRD FLOOR
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-1078
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Country | US
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Telephone | 415-668-3200
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Fax | 415-668-2010
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN M RABKIN
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Credential | MD
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Telephone | 415-668-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G51241
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA17826
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License Number State | CA
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