MEDICARE: JON CHRISTOPHER RASAK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G76839	CA

General Provider Information

NPI Number	:	1376524371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON CHRISTOPHER RASAK MD

Provider Business Mailing Address
First Line	:	200 PORTER DR
Second Line	:	STE 300
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1587
Country	:	US
Telephone Number	:	925-838-6533
Fax Number	:	925-838-6544

Provider Business Practice Location Address
First Line	:	8767 WILSHIRE BLVD FL 2
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2714
Country	:	US
Telephone Number	:	310-385-2977
Fax Number	:	464-385-2977

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	03/01/2021

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