MEDICARE: DR. ELENA RAPOPORT 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	2084P0800X	Psychiatry Physician	A84954	CA

General Provider Information

NPI Number	:	1639242001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELENA RAPOPORT MD

Provider Business Mailing Address
First Line	:	4120 DOUGLAS BLVD # 306-341
Second Line	:
City	:	GRANITE BAY
State	:	CA
Zip	:	95746-5936
Country	:	US
Telephone Number	:	916-915-3695
Fax Number	:	949-203-3044

Provider Business Practice Location Address
First Line	:	9700 VILLAGE CENTER DR STE 111
Second Line	:
City	:	GRANITE BAY
State	:	CA
Zip	:	95746-6313
Country	:	US
Telephone Number	:	916-695-9131
Fax Number	:	916-474-4527

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	12/04/2025

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