Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | G51241 | CA |
N | 208200000X | Surgeon | G51241 | CA |
N | 208600000X | Surgeon | G51241 | CA |
NPI | 1811042179 |
---|---|
Provider Name | John Rabkin |
First Address | Portland, OR 97201-2386 |
Second Address | Portland, OR 97201-2386 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 24/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F07004 | (02) | CA |