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General NPI Number Information
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NPI Number | 1902926629
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Entity Type | Individual
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Provider Name | MARVIN ARNOLD RAWITCH MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 E VALENCIA MESA DR ST JUDE MEDICAL CENTER
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City | FULLERTON
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State | CA
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Zip | 92835
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Country | US
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Telephone | 714-992-3978
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Fax | 714-992-3928
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Provider Business Mailing Address
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Address Line | 24100 D EL TORO RD #69
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-3129
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Country | US
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Telephone | 714-402-7074
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Fax | 949-859-0532
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G4184
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License Number State | CA
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