Provider Demographics
NPI:1063570844
Name:ALLAN H. RABIN, M.D., INC.
Entity type:Organization
Organization Name:ALLAN H. RABIN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:RABIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-565-1167
Mailing Address - Street 1:PO BOX 1770
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91944-1770
Mailing Address - Country:US
Mailing Address - Phone:858-565-1167
Mailing Address - Fax:619-284-5605
Practice Address - Street 1:4540 KEARNY VILLA RD
Practice Address - Street 2:#117
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1571
Practice Address - Country:US
Practice Address - Phone:858-565-1167
Practice Address - Fax:619-284-5605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG105342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG10534Medicare ID - Type Unspecified
CAE02587Medicare UPIN